Kids’ Access to Primary Care Act of 2023

No Bill No. - Congressional Primary Care Caucus No Bill No. - Black Maternal Health Momnibus Act No Bill No. - Medicare Physician Payment Reform No Bill No. - MACRA Implementation No Bill No. - CY2024 Medicare Physician Fee Schedule No Bill No. - CY 2024 Medicare Inpatient Prospective Payment System No Bill No. - Site Neutrality and Consolidation No Bill No. - CMS Prior Authorization Rules No Bill No. - Tobacco Users Quiet Act No Bill No. - G2211 Code (Physician Fee Schedule) No Bill No. - Reducing Medically Unnecessary Delays in Care Act No Bill No. - G2211 implementation/modifier 25 No Bill No. - HEALTH for Mom Act No Bill No. - Pay PCP Act No Bill No. - Seniors Timely Access to Care Act No Bill No. - CY25 Medicare Physician Fee Schedule No Bill No. - Physician Fee Stabilization Act (H.R. 952) Kids Access to Primary Care Act (H.R. 2400/S. 1165) The Reentry Act (H.R. 3074) Due Process Continuity of Care Act (H.R. 3766) Extending Access to Addiction Treatment Act (H.R. 4950/S. 2841) Improve Addiction Care Act (H.R. 4771) Children's Health Insurance Program Permanency Act (H.R. 4968) GOLD Card Act of 2023 (S. 2556) Improving Care for Youth Act (H.R. 5013) Value in Health Care Act (S. 2816) Medicaid for Every Child Act (H.R. 6545) Physician Fee Schedule Update and Improvements Act (H.R. 5434/S.3138) Stabilize Medicaid and CHIP Coverage Act (H.R. 5395) SURS Extension Act (H.R. 3487/S. 3805) No Fees for EFTs Act (S. 1316) Save Children's Coverage Act (H.R. 6997/S. 3010) Nutrition CARE Act (H.R. 6780/S. 2133) - Medically Tailored Home-Delivered Meals Demonstration Pilot Act (H.R. 8235) - Rural Physician Workforce Preservation Act (H.R. 7512) - Real-Time Benefit Tool Implementation Act (H.R. 1770/S. 2477) - Equitable Community Access to Pharmacist Act (S. 4349) - Electronic Prior Authorization for Prescription Drugs Act (H.R. 5434/S. 3138) - Stabilize Medicaid and CHIP Coverage Act

Client expense: $928,743 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

No Bill No. - Congressional Primary Care Caucus No Bill No. - Black Maternal Health Momnibus Act No Bill No. - Medicare Physician Payment Reform No Bill No. - MACRA Implementation No Bill No. - CY2024 Medicare Physician Fee Schedule No Bill No. - CY 2024 Medicare Inpatient Prospective Payment System No Bill No. - Site Neutrality and Consolidation No Bill No. - CMS Prior Authorization Rules No Bill No. - Tobacco Users Quiet Act No Bill No. - G2211 Code (Physician Fee Schedule) No Bill No. - Reducing Medically Unnecessary Delays in Care Act No Bill No. - G2211 implementation/modifier 25 No Bill No. - HEALTH for Mom Act No Bill No. - Pay PCP Act No Bill No. - Seniors Timely Access to Care Act (H.R. 952) Kids Access to Primary Care Act (H.R. 2400/S. 1165) The Reentry Act (H.R. 3074) Due Process Continuity of Care Act (H.R. 3766) Extending Access to Addiction Treatment Act (H.R. 4950/S. 2841) Improve Addiction Care Act (H.R. 4771) Children's Health Insurance Program Permanency Act (H.R. 4968) GOLD Card Act of 2023 (S. 2556) Improving Care for Youth Act (H.R. 5013) Value in Health Care Act (S. 2816) Medicaid for Every Child Act (H.R. 6545) Physician Fee Schedule Update and Improvements Act (H.R. 5434/S.3138) Stabilize Medicaid and CHIP Coverage Act (H.R. 5395) SURS Extension Act (H.R. 3487/S. 3805) No Fees for EFTs Act (S. 1316) Save Children's Coverage Act (H.R. 6997/S. 3010) Nutrition CARE Act (H.R. 6780/S. 2133) - Medically Tailored Home-Delivered Meals Demonstration Pilot Act (H.R. 8235) - Rural Physician Workforce Preservation Act (H.R. 7512) - Real-Time Benefit Tool Implementation Act

Client expense: $1,045,426 · Firm income: Not reported

Standards in ORR Custody ORR, HHS; Licensure of ORR Shelters ORR, HHS; Public Charge; Child Nutrition Reauthorization/WIC USDA; SNAP/Farm Bill USDA; Mental Health for Children HRSA; H.R. 6, DREAM Act; Medical Nutrition Equity Act; Lift the Bar Act (H.R. 4170/S. 2038); PAHPA Reauthorization; CARE for Families Act HR 3107; WIC Act (S. 1604/H.R. 3364); MODERN WIC Act (S. 984/H.R. 2424) Child passenger safety; Appropriations for the Indian Health Service HIS; Appropriations for Environmental Programs (including EPA) EPA; Maternal, Infant, and Early Childhood Home Visiting Program Reauthorization & Implementation HRSA, CMS, HHS, ACF; Infant sleep product safety CPSC; Lead exposure prevention EPA, CDC; Food safety FDA; Paid family and medical leave; Regulation of high-powered magnet sets CPSC; Climate change, Inflation Reduction Act Implementation EPA; Vehicle emissions standards EPA, NHTSA ; Button battery ingestions CPSC; Early childhood education HHS; Child product safety and injury prevention CPSC; Furniture tip-overs CPSC; Child Abuse Prevention and Treatment Act (CAPTA) Reauthorization; CAPTA Plans of safe care grants ACF, HHS ASPE; Family First Prevention Services Act implementation ACF; CAPTA Fatalities Prevention and Response HHS; Title IV-B Reauthorization ACF; Congregate care reform HHS, ACF; Mental health supports for foster youth/former foster youth HHS; Mercury and Air Toxics Standards, ozone and particulate matter NAAQS, EPA greenhouse gas regulation EPA; QRTP/IMDs (including H.R. 4056 - Ensuring Medicaid Continuity for Children in Foster Care Act of 2023) ACF; Firearm Violence Prevention (Including Research Funding; Background Checks); WH Domestic Policy Council; CDC; NIH; DOJ; Pregnant Workers Fairness Act Implementation EEOC; Childcare Funding & Resources HHS; Native American Child Health DOI; EPA Strengthening Efforts to End Violence Against Children Act (H.R. 4798); PEPFAR Reauthorization; MINDS Act (H.R. 1570/S. 767); Implementation of the Global Child Thrive Act; FY24 Appropriations - SFOPS bill focused on specifically on global child health subaccounts at USAID (Vulnerable Children, Nutrition, Maternal and Child Health, and PEPFAR); FY25 Appropriations - SFOPS bill focused specifically on global child health subaccounts at USAID (Vulnerable Children, Nutrition, HIV/AIDS, Maternal and Child Health (including Gavi), WASH, PEPFAR), Department of State Child Protection Compacts, Efforts to end Child Marriage, IDA, MRA; FY24 Appropriations - LHHS bill focused specifically on CDCs global health account (Global Immunization Division), Violence Against Children Surveys, Bureau of International Labor Affairs; FY25 Appropriations - LHHS bill focused on CDCs global health account, Violence Against Children Surveys, Bureau of International Labor Affairs; USAID Advancing Protection and Care for Children in Adversity Strategy 2024-2028 Kids Online Safety Act (S. 1409/H.R. 7891); Children and Teens Online Privacy Protection Act (S. 1418/H.R. 7890); Legislation to Protect Young People Online; Pediatric Subspecialty Loan Repayment Program Funding and Program Implementation Health Resources and Services Administration; Adolescent Health Issues Department of Health and Human Services Office of the Assistant Secretary for Health; Regulation of Tobacco Products (including Proposed Menthol Cigarette and Flavored Cigar Prohibition); Food and Drug Administration; Innovation in Pediatric Drugs Act (H.R. 6664) Continuous Eligibility for Children in Medicaid and CHIP HHS/CMS; Medicaid Payment Parity HHS/CMS; The Kids Access to Primary Care Act (HR 952); Access to Care in Medicaid/CHIP HHS/CMS; Postpartum Medicaid Extension and Maternal Health Improvements; Medicaid/CHIP Eligibility Redeterminations HHS/CMS; Ex Parte Medicaid Unwinding Issues HHS/CMS; Medicaid for Every Child Act (S. 2816); QRTP/IMDs (including H.R. 4056 - Ensuring Medicaid Continuity for Children in Foster Care Act of 2023, and S. 3196 - Ensuring Medicaid Continuity for Children in Foster Care Act of 2023); Accelerating Kids Access to Care Act (HR 4758, S 2372); Childrens oral health; Medicaid Early and Periodic Screening, Diagnostic, and Treatment benefit HHS/CMS; Medicaid payment for family caregivers HHS/CMS; Vaccines for Children program improvements HHS/CMS, CDC FY25 Labor, Health and Human Services, and Education Appropriations Bill: Pediatric Subspecialty Loan Repayment Program, Firearm Injury and Mortality Prevention Research, Pediatric Mental Health Care Access Program, Emergency Medical Services for Children, National Center for Birth Defects and Developmental Disabilities, Global Immunization, Sudden Unexpected Infant Death and Sudden Death in Childhood, Vaccine Injury Compensation Program, VACCINES Act, Antimicrobial Resistance, Maternal and Child Health, School Based Health Centers, Healthy Start, Section 317 Immunization Grants; FY25 Agriculture, Rural Development, Food and Drug Administration Appropriations Bill: Pediatric Device Consortia; Newborn Screening Saves Lives Reauthorization Act; FY25 National Defense Authorization Act; Department of Defense / Defense Health Agency; Defense Health Agency - Autism Care Demonstration; Department of Defense / Defense Health Agency; Defense Health Agency - Fluoride varnish; Department of Defense/Defense Health Agency; Improving the Health of Children Act; Strengthening the Vaccines for Children Program Act; Banning Electronic Stimulation Devices FDA; SSI Savings Penalty Elimination Act (S.2767/H.R.5408); HCBS Access Act (S.762/H.R. 1493); Better Care Better Jobs Act (S.100/H.R. 547); Autism Family Caregivers Act; PREVENT HPV Cancers Act (H.R. 3633); Supplemental Security Income Equality Act (H.R. 256); IDEA Full Funding Act (S.2217/H.R.4519); Promoting Physical Activity for Americans Act (S.397); COVID-19 Commercialization CDC, HHS; Pandemic and All Hazards Preparedness Act (PAHPA); PREEMIE Reauthorization Act (H.R. 3226/S. 1573); Autism CARES Reauthorization Act; Supplemental Security Income/Social Security; Social Security Administration; School Access to Naloxone Act (H.R. 3065); HEADs UP Act (H.R. 3380); Preventing Maternal Deaths Reauthorization Act of 2023 (S. 2415/H.R.3838); Youth Sports Facilities Act; SHINE for Autumn Act (H.R.5012/S.2647); Artificial Intelligence; Congenital Heart Futures Reauthorization Act (S.3757); HERO Act (H.R. 6251); SSI Restoration Act (H.R. 7138); NURSE Act (S. 3953/H.R. 3197); Vaccines for Children coverage of Nirsevimab CDC, HHS

Kids Online Safety Act (S. 1409/H.R. 7891); Children and Teens Online Privacy Protection Act (S. 1418/H.R. 7890); Legislation to Protect Young People Online; Pediatric Subspecialty Loan Repayment Program Funding and Program Implementation-Health Resources and Services Administration; Adolescent Health Issues-Department of Health and Human Services Office of the Assistant Secretary for Health; Regulation of Tobacco Products (including Proposed Menthol Cigarette and Flavored Cigar Prohibition)-Food and Drug Administration; Innovation in Pediatric Drugs Act (H.R. 6664). Continuous Eligibility for Children in Medicaid and CHIP-HHS/CMS; Medicaid Payment Parity-HHS/CMS; The Kids Access to Primary Care Act (HR 952); Access to Care in Medicaid/CHIP-HHS/CMS; Postpartum Medicaid Extension and Maternal Health Improvements; Medicaid/CHIP Eligibility Redeterminations-HHS/CMS; Ex Parte Medicaid Unwinding Issues-HHS/CMS; Medicaid for Every Child Act (S. 2816); QRTP/IMDs (including H.R. 4056-Ensuring Medicaid Continuity for Children in Foster Care Act of 2023, and S. 3196-Ensuring Medicaid Continuity for Children in Foster Care Act of 2023); Accelerating Kids Access to Care Act (HR 4758, S 2372); Medicaid Early and Periodic Screening, Diagnostic, and Treatment benefit-HHS/CMS; Medicaid payment for family caregivers-HHS/CMS; Vaccines for Children program improvements-HHS/CMS, CDC. Standards in ORR Custody-ORR, HHS; Licensure of ORR Shelters-ORR, HHS; Public Charge; Child Nutrition Reauthorization/WIC-USDA; SNAP/Farm Bill-USDA; Mental Health for Children-HRSA; H.R. 6, DREAM Act; Medical Nutrition Equity Act; Lift the Bar Act (H.R. 4170/S. 2038); PAHPA Reauthorization; CARE for Families Act HR 3107; WIC Act (S. 1604/H.R. 3364); MODERN WIC Act (S. 984/H.R. 2424); Breastfeeding Peer Counseling Program-USDA; Public Health Preparedness and Response-ASPR; National Advisory Committee on Children and Disasters; Research for Pregnant and Lactating Women-FDA, HHS, NIH; Advancing Safe Medications for Moms and Babies Act; Funding for Pediatric Device Consortia; Funding for Emergency Medical Services for Children Program; Funding for HRSA Pediatric Mental Health Care Access Program; Funding for WIC-OMB, USDA; Donor Milk (S. 2819/H.R. 5486); Dietary Guidelines-USDA, HHS; Child Poverty; Child Poverty Reduction Act (H.R. 5629/S. 2906); Suicide Prevention-SAMHSA; School Meal Standards-USDA; WIC Food Packages-USDA; Universal School Meals (H.R. 3204/S. 1568)-USDA, White House; Early Childhood Nutrition Improvement Act (H.R. 6067); Unaccompanied Children (Fair Day in Court for Kids Act of 2023 - S. 3065); Equality Act; Mental Health Services for Students Act (H.R. 3713); Youth Mental Health and Suicide Prevention Act; Child Tax Credit (H.R. 7024); Supporting Children's Mental Health Care Access Act; Gender Affirming Care-HHS; Safety of Pediatricians and Children's Hospitals-DOJ, HHS; Same Day Billing Restrictions in Mental Health (S. 2556/H.R. 7996); Emergency Vacating of Aircraft Cabin (EVAC) Act; FAA Reauthorization/ Emergency Medical Kits; Drug Shortage Prevention Act; Prevention and Early Intervention Set-Aside in Mental Health Block Grant (H.R. 7808); Child Poverty Reduction Act (S. 2906/H.R. 5629); Compact Impact Fairness Act (S. 792/H.R. 1571); Improving Mental Health and Wellness in Schools Act (H.R. 3331/S. 754); Pride in Mental Health Act (H.R. 7644); Therapeutic Fraud Prevention Act (S. 2176/H.R. 4340); Cady Housh and Gemesha Thomas Student Suicide Prevention Act (H.R. 3778); School Meals Expansion Act (H.R. 2567); Pursuing Equity in Mental Health Act (H.R. 3713); EMSC Reauthorization Act of 2024 (H.R. 6960, S. 3765); CARE for Kids Act; School Hunger Elimination Act; Nutrition Red Tape Reduction Act; No Hungry Kids in Schools Act; Expanding Access to School Meals Act; Innovation in Pediatric Drugs Act; US Senate Commission on Mental Health Act of 2024. FY25 Labor, Health and Human Services, and Education Appropriations Bill: Pediatric Subspecialty Loan Repayment Program, Firearm Injury and Mortality Prevention Research, Pediatric Mental Health Care Access Program, Emergency Medical Services for Children, National Center for Birth Defects and Developmental Disabilities, Global Immunization, Sudden Unexpected Infant Death and Sudden Death in Childhood, Vaccine Injury Compensation Program, VACCINES Act, Antimicrobial Resistance, Maternal and Child Health, School Based Health Centers, Healthy Start, Section 317 Immunization Grants; FY25 Agriculture, Rural Development, Food and Drug Administration Appropriations Bill: Pediatric Device Consortia; Newborn Screening Saves Lives Reauthorization Act; FY25 National Defense Authorization Act-Department of Defense/Defense Health Agency; Defense Health Agency-Autism Care Demonstration-Department of Defense/Defense Health Agency; Defense Health Agency-Fluoride varnish-Department of Defense/Defense Health Agency; Improving the Health of Children Act; Strengthening the Vaccines for Children Program Act; Banning Electronic Stimulation Devices-FDA; SSI Savings Penalty Elimination Act (S.2767/H.R.5408); HCBS Access Act (S.762/H.R. 1493); Better Care Better Jobs Act (S.100/H.R. 547); Autism Family Caregivers Act; PREVENT HPV Cancers Act (H.R. 3633); Supplemental Security Income Equality Act (H.R. 256); IDEA Full Funding Act (S.2217/H.R.4519); Promoting Physical Activity for Americans Act (S.397); Pandemic and All Hazards Preparedness Act (PAHPA); PREEMIE Reauthorization Act (H.R. 3226/S. 1573); Autism CARES Act of 2024 (H.R. 7213); Supplemental Security Income/Social Security Social Security Administration School Access to Naloxone Act (H.R. 3065); HEADs UP Act (H.R. 3380); Preventing Maternal Deaths Reauthorization Act of 2023 (S. 2415/H.R.3838); Youth Sports Facilities Act; SHINE for Autumn Act (H.R.5012/S.2647); Artificial Intelligence; Congenital Heart Futures Reauthorization Act (S.3757); HERO Act (H.R. 6251); SSI Restoration Act (H.R. 7138); NURSE Act (S. 3953/H.R. 3197); Vaccines for Children coverage of Nirsevimab and COVID-19 immunizations-CDC, HHS; WEAR IT Act (H.R. 6279). Child passenger safety; Appropriations for the Indian Health Service-IHS; Appropriations for Environmental Programs (including EPA)-EPA; Maternal, Infant, and Early Childhood Home Visiting Program Reauthorization & Implementation-HRSA, CMS, HHS, ACF; Infant sleep product safety-CPSC; Lead exposure prevention-EPA, CDC; Food safety-FDA; Paid family and medical leave; Regulation of high-powered magnet sets-CPSC; Climate change, Inflation Reduction Act Implementation-EPA; Vehicle emissions standards-EPA, NHTSA; Button battery ingestions-CPSC; Early childhood education-HHS; Child product safety and injury prevention-CPSC; Furniture tip-overs-CPSC; Child Abuse Prevention and Treatment Act (CAPTA) Reauthorization; CAPTA Plans of safe care grants-ACF, HHS ASPE; Family First Prevention Services Act implementation-ACF; CAPTA Fatalities Prevention and Response-HHS; Title IV-B Reauthorization-ACF; Congregate care reform-HHS, ACF; Mental health supports for foster youth/former foster youth-HHS; Mercury and Air Toxics Standards, ozone and particulate matter NAAQS, EPA greenhouse gas regulation-EPA; QRTP/IMDs (including H.R. 4056 - Ensuring Medicaid Continuity for Children in Foster Care Act of 2023)-ACF; Firearm Violence Prevention (Including Research Funding; Background Checks)-WH Domestic Policy Council, WH Office of Gun Violence Prevention, CDC, NIH, DOJ; Pregnant Workers Fairness Act Implementation-EEOC; Childcare Funding & Resources-HHS; Native American Child Health-DOI, EPA; Water Beads (including Ban Water Beads Act)-CPSC. Strengthening Efforts to End Violence Against Children Act (H.R. 4798); MINDS Act (H.R. 1570/S. 767); Implementation of the Global Child Thrive Act-USAID; FY25 Appropriations - SFOPS bill (overall foreign assistance funding: Vulnerable Children, Nutrition, Maternal and Child Health (including Gavi), WASH, Department of State Child Protection Compacts, Efforts to end Child Marriage, IDA, MRA); FY25 Appropriations - LHHS bill focused on CDCs global immunization account, Violence Against Children Surveys, Bureau of International Labor Affairs; FY26 Appropriations - global child health accounts impacting children and youth at USAID (Vulnerable Children, International Basic Education, Maternal and Child Health, Nutrition), Combating Child, Early and Forced Marriage, McGovern-Dole International Food for Education and Child Nutrition Program, Department of State Child Protection Compact (CPC) Partnership, ILAB, UNICEF, IDA, MRA, PEPFAR-OMB; Violence Against Children Ministerial Meeting-HHS, NSC, USAID; Supporting U.S. Program to Protect Vaccines and Immunizations in Low-Income Countries through Gavi, the Vaccine Alliance (H. Res. 1286 / S. Res. 684); Advocacy on the unique humanitarian needs of children in Gaza-USAID.

No Bill No. - Congressional Primary Care Caucus No Bill No. - Black Maternal Health Momnibus Act No Bill No. - Medicare Physician Payment Reform No Bill No. - MACRA Implementation No Bill No. - CY2024 Medicare Physician Fee Schedule No Bill No. - CY 2024 Medicare Inpatient Prospective Payment System No Bill No. - Site Neutrality and Consolidation No Bill No. - CMS Prior Authorization Rules No Bill No. - Tobacco Users Quiet Act No Bill No. - G2211 Code (Physician Fee Schedule) No Bill No. - Reducing Medically Unnecessary Delays in Care Act No Bill No. - G2211 implementation/modifier 25 No Bill No. - HEALTH for Mom Act No Bill No. - Pay PCP Act No Bill No. - Seniors Timely Access to Care Act (H.R. 952) Kids Access to Primary Care Act (H.R. 2400/S. 1165) The Reentry Act (H.R. 3074) Due Process Continuity of Care Act (H.R. 3766) Extending Access to Addiction Treatment Act (H.R. 4950/S. 2841) Improve Addiction Care Act (H.R. 4771) Children's Health Insurance Program Permanency Act (H.R. 4968) GOLD Card Act of 2023 (S. 2556) Improving Care for Youth Act (H.R. 5013) Value in Health Care Act (S. 2816) Medicaid for Every Child Act (H.R. 6545) Physician Fee Schedule Update and Improvements Act (H.R. 5434/S.3138) Stabilize Medicaid and CHIP Coverage Act (H.R. 5395) SURS Extension Act (H.R. 3487/S. 3805) No Fees for EFTs Act (S. 1316) Save Children's Coverage Act (H.R. 6997/S. 3010) Nutrition CARE Act (H.R. 6780/S. 2133) - Medically Tailored Home-Delivered Meals Demonstration Pilot Act (H.R. 8235) - Rural Physician Workforce Preservation Act (H.R. 7512) - Real-Time Benefit Tool Implementation Act

Client expense: $1,045,426 · Firm income: Not reported

Standards in ORR Custody ORR, HHS; Licensure of ORR Shelters ORR, HHS; Public Charge; Child Nutrition Reauthorization/WIC USDA; SNAP/Farm Bill USDA; Mental Health for Children HRSA; H.R. 6, DREAM Act; Medical Nutrition Equity Act; Lift the Bar Act (H.R. 4170/S. 2038); PAHPA Reauthorization; CARE for Families Act HR 3107; WIC Act (S. 1604/H.R. 3364); MODERN WIC Act (S. 984/H.R. 2424) Child passenger safety; Appropriations for the Indian Health Service HIS; Appropriations for Environmental Programs (including EPA) EPA; Maternal, Infant, and Early Childhood Home Visiting Program Reauthorization & Implementation HRSA, CMS, HHS, ACF; Infant sleep product safety CPSC; Lead exposure prevention EPA, CDC; Food safety FDA; Paid family and medical leave; Regulation of high-powered magnet sets CPSC; Climate change, Inflation Reduction Act Implementation EPA; Vehicle emissions standards EPA, NHTSA ; Button battery ingestions CPSC; Early childhood education HHS; Child product safety and injury prevention CPSC; Furniture tip-overs CPSC; Child Abuse Prevention and Treatment Act (CAPTA) Reauthorization; CAPTA Plans of safe care grants ACF, HHS ASPE; Family First Prevention Services Act implementation ACF; CAPTA Fatalities Prevention and Response HHS; Title IV-B Reauthorization ACF; Congregate care reform HHS, ACF; Mental health supports for foster youth/former foster youth HHS; Mercury and Air Toxics Standards, ozone and particulate matter NAAQS, EPA greenhouse gas regulation EPA; QRTP/IMDs (including H.R. 4056 - Ensuring Medicaid Continuity for Children in Foster Care Act of 2023) ACF; Firearm Violence Prevention (Including Research Funding; Background Checks); WH Domestic Policy Council; CDC; NIH; DOJ; Pregnant Workers Fairness Act Implementation EEOC; Childcare Funding & Resources HHS; Native American Child Health DOI; EPA Strengthening Efforts to End Violence Against Children Act (H.R. 4798); PEPFAR Reauthorization; MINDS Act (H.R. 1570/S. 767); Implementation of the Global Child Thrive Act; FY24 Appropriations - SFOPS bill focused on specifically on global child health subaccounts at USAID (Vulnerable Children, Nutrition, Maternal and Child Health, and PEPFAR); FY25 Appropriations - SFOPS bill focused specifically on global child health subaccounts at USAID (Vulnerable Children, Nutrition, HIV/AIDS, Maternal and Child Health (including Gavi), WASH, PEPFAR), Department of State Child Protection Compacts, Efforts to end Child Marriage, IDA, MRA; FY24 Appropriations - LHHS bill focused specifically on CDCs global health account (Global Immunization Division), Violence Against Children Surveys, Bureau of International Labor Affairs; FY25 Appropriations - LHHS bill focused on CDCs global health account, Violence Against Children Surveys, Bureau of International Labor Affairs; USAID Advancing Protection and Care for Children in Adversity Strategy 2024-2028 Kids Online Safety Act (S. 1409/H.R. 7891); Children and Teens Online Privacy Protection Act (S. 1418/H.R. 7890); Legislation to Protect Young People Online; Pediatric Subspecialty Loan Repayment Program Funding and Program Implementation Health Resources and Services Administration; Adolescent Health Issues Department of Health and Human Services Office of the Assistant Secretary for Health; Regulation of Tobacco Products (including Proposed Menthol Cigarette and Flavored Cigar Prohibition); Food and Drug Administration; Innovation in Pediatric Drugs Act (H.R. 6664) Continuous Eligibility for Children in Medicaid and CHIP HHS/CMS; Medicaid Payment Parity HHS/CMS; The Kids Access to Primary Care Act (HR 952); Access to Care in Medicaid/CHIP HHS/CMS; Postpartum Medicaid Extension and Maternal Health Improvements; Medicaid/CHIP Eligibility Redeterminations HHS/CMS; Ex Parte Medicaid Unwinding Issues HHS/CMS; Medicaid for Every Child Act (S. 2816); QRTP/IMDs (including H.R. 4056 - Ensuring Medicaid Continuity for Children in Foster Care Act of 2023, and S. 3196 - Ensuring Medicaid Continuity for Children in Foster Care Act of 2023); Accelerating Kids Access to Care Act (HR 4758, S 2372); Childrens oral health; Medicaid Early and Periodic Screening, Diagnostic, and Treatment benefit HHS/CMS; Medicaid payment for family caregivers HHS/CMS; Vaccines for Children program improvements HHS/CMS, CDC FY25 Labor, Health and Human Services, and Education Appropriations Bill: Pediatric Subspecialty Loan Repayment Program, Firearm Injury and Mortality Prevention Research, Pediatric Mental Health Care Access Program, Emergency Medical Services for Children, National Center for Birth Defects and Developmental Disabilities, Global Immunization, Sudden Unexpected Infant Death and Sudden Death in Childhood, Vaccine Injury Compensation Program, VACCINES Act, Antimicrobial Resistance, Maternal and Child Health, School Based Health Centers, Healthy Start, Section 317 Immunization Grants; FY25 Agriculture, Rural Development, Food and Drug Administration Appropriations Bill: Pediatric Device Consortia; Newborn Screening Saves Lives Reauthorization Act; FY25 National Defense Authorization Act; Department of Defense / Defense Health Agency; Defense Health Agency - Autism Care Demonstration; Department of Defense / Defense Health Agency; Defense Health Agency - Fluoride varnish; Department of Defense/Defense Health Agency; Improving the Health of Children Act; Strengthening the Vaccines for Children Program Act; Banning Electronic Stimulation Devices FDA; SSI Savings Penalty Elimination Act (S.2767/H.R.5408); HCBS Access Act (S.762/H.R. 1493); Better Care Better Jobs Act (S.100/H.R. 547); Autism Family Caregivers Act; PREVENT HPV Cancers Act (H.R. 3633); Supplemental Security Income Equality Act (H.R. 256); IDEA Full Funding Act (S.2217/H.R.4519); Promoting Physical Activity for Americans Act (S.397); COVID-19 Commercialization CDC, HHS; Pandemic and All Hazards Preparedness Act (PAHPA); PREEMIE Reauthorization Act (H.R. 3226/S. 1573); Autism CARES Reauthorization Act; Supplemental Security Income/Social Security; Social Security Administration; School Access to Naloxone Act (H.R. 3065); HEADs UP Act (H.R. 3380); Preventing Maternal Deaths Reauthorization Act of 2023 (S. 2415/H.R.3838); Youth Sports Facilities Act; SHINE for Autumn Act (H.R.5012/S.2647); Artificial Intelligence; Congenital Heart Futures Reauthorization Act (S.3757); HERO Act (H.R. 6251); SSI Restoration Act (H.R. 7138); NURSE Act (S. 3953/H.R. 3197); Vaccines for Children coverage of Nirsevimab CDC, HHS

No Bill No. - Congressional Primary Care Caucus No Bill No. - Black Maternal Health Momnibus Act No Bill No. - Medicare Physician Payment Reform No Bill No. - MACRA Implementation No Bill No. - CY2024 Medicare Physician Fee Schedule No Bill No. - CY 2024 Medicare Inpatient Prospective Payment System No Bill No. - Site Neutrality and Consolidation No Bill No. - CMS Prior Authorization Rules No Bill No. - Tobacco Users Quiet Act No Bill No. - G2211 Code (Physician Fee Schedule) No Bill No. - Reducing Medically Unnecessary Delays in Care Act No Bill No. - G2211 implementation/modifier 25 (H.R. 952) Kids Access to Primary Care Act (H.R. 2400/S. 1165) The Reentry Act (H.R. 3074) Due Process Continuity of Care Act (H.R. 3766) Extending Access to Addiction Treatment Act (H.R. 4950/S. 2841) Improve Addiction Care Act (H.R. 4771) Children's Health Insurance Program Permanency Act (H.R. 4968) GOLD Card Act of 2023 (S. 2556) Improving Care for Youth Act (H.R. 5013) Value in Health Care Act (S. 2816) Medicaid for Every Child Act (H.R. 6545) Physician Fee Schedule Update and Improvements Act (H.R. 5434/S.3138) Stabilize Medicaid and CHIP Coverage Act (H.R. 5395) SURS Extension Act (H.R. 3487/S. 3805) No Fees for EFTs Act (S. 1316) Save Children's Coverage Act (H.R. 6997/S. 3010) Nutrition CARE Act (H.R. 6780/S. 2133) - Medically Tailored Home-Delivered Meals Demonstration Pilot Act

Client expense: $825,016 · Firm income: Not reported

Abortion access (general); Access to Mifepristone (general); Contraception (general); Maternal Mortality and Morbidity (general); H.R. 1117, Advancing Safe Medications for Moms and Babies Act; obstetric and gynecologic care in rural areas (general; H.R. 3305/S. 1606, Black Maternal Health Momnibus Act; H.R. 952, Kids Access to Primary Care Act of 2023; H.R. 1202/S. 704, Resident Education Deferred Interest (REDI) Act; H.R. 4933/S. 462, Mental Health Professionals Workforce Shortage Loan Repayment Act of 2023; H.R. 2389/S. 1302, Resident Physician Shortage Reduction Act of 2023; H.R. 2569, Doctors of Community (DOC) Act; Teaching Health Center Graduate Medication Education (general); physician workforce and training (general); H.R. 3838/S. 2415, Preventing Maternal Deaths Reauthorization Act of 2023; H.R. 3226/S. 1573, PREEMIE Reauthorization Act of 2023; inclusion of pregnant and lactating individuals in research (general); Implementation of P.L. 115-320, Improving Access to Maternity Care Act; telemedicine (general); H.R. 5012/S. 2647, SHINE for Autumn Act; Rural Residency Planning and Development (RRPD) Program; H.R. 4581/S. 2231, Maternal and Child Health Stillbirth Prevention Act; Implementation of P.L. 117-328, Consolidated Appropriations Act, including the Pregnant Workers Fairness Act; Health Insurance Portability and Accountability Act (general); patient-physician relationship (general); H.R. 4605/S. 948, Healthy Moms and Babies Act; H.R. 4816/S. 2427, Convenient Contraception Act; Cost-sharing for maternity care (general); H.R. 4796/S. 2439, Reproductive Health Patient Navigator Act; H.R. 4731/S. 2386, Access to Infertility Treatment and Care Act; H.R. 5066, Tech to Save Moms Act; H.R. 4901/S. 2544, Reproductive Health Care Accessibility Act; Conscientious refusals in medicine (general); H.R. 834/S. 230, Rural Physician Workforce Production Act; menopause research (general); Alliance for Innovation on Maternal Health; Residency programs in obstetrics and gynecology (general); H.R. 5568/S. 2846, CARE for Moms Act; Value-based care models for obstetrics and gynecology (general); S. 3006, SAFE in Recovery Act; H.R. 4775, Helping Tobacco Users Quit Act; Treatment of reproductive health information under the Stored Communications Act (general); Congenital syphilis (general); Tax treatment of stillbirths (general); Substance use disorder during pregnancy (general); H.R. 117, NEWBORN Act; Physician burnout (general); Maternal mental health (general).

Abortion access (general); Access to Mifepristone (general); Contraception (general); Maternal Mortality and Morbidity (general); H.R. 1117, Advancing Safe Medications for Moms and Babies Act; obstetric and gynecologic care in rural areas (general; H.R. 3305/S. 1606, Black Maternal Health Momnibus Act; H.R. 952, Kids Access to Primary Care Act of 2023; H.R. 1202/S. 704, Resident Education Deferred Interest (REDI) Act; H.R. 4933/S. 462, Mental Health Professionals Workforce Shortage Loan Repayment Act of 2023; H.R. 2389/S. 1302, Resident Physician Shortage Reduction Act of 2023; H.R. 2569, Doctors of Community (DOC) Act; Teaching Health Center Graduate Medication Education (general); physician workforce and training (general); H.R. 3838/S. 2415, Preventing Maternal Deaths Reauthorization Act of 2023; H.R. 3226/S. 1573, PREEMIE Reauthorization Act of 2023; inclusion of pregnant and lactating individuals in research (general); Implementation of P.L. 115-320, Improving Access to Maternity Care Act; telemedicine (general); H.R. 5012/S. 2647, SHINE for Autumn Act; Rural Residency Planning and Development (RRPD) Program; H.R. 4581/S. 2231, Maternal and Child Health Stillbirth Prevention Act; Implementation of P.L. 117-328, Consolidated Appropriations Act, including the Pregnant Workers Fairness Act; Health Insurance Portability and Accountability Act (general); patient-physician relationship (general); H.R. 4605/S. 948, Healthy Moms and Babies Act; H.R. 4816/S. 2427, Convenient Contraception Act; Cost-sharing for maternity care (general); H.R. 4796/S. 2439, Reproductive Health Patient Navigator Act; H.R. 4731/S. 2386, Access to Infertility Treatment and Care Act; H.R. 5066, Tech to Save Moms Act; H.R. 4901/S. 2544, Reproductive Health Care Accessibility Act; Conscientious refusals in medicine (general); H.R. 834/S. 230, Rural Physician Workforce Production Act; menopause research (general); Alliance for Innovation on Maternal Health; Residency programs in obstetrics and gynecology (general); H.R. 5568/S. 2846, CARE for Moms Act; Value-based care models for obstetrics and gynecology (general); S. 3006, SAFE in Recovery Act; H.R. 4775, Helping Tobacco Users Quit Act; Treatment of reproductive health information under the Stored Communications Act (general); Congenital syphilis (general); Tax treatment of stillbirths (general); Substance use disorder during pregnancy (general); H.R. 117, NEWBORN Act; Physician burnout (general); Maternal mental health (general).

Abortion access (general); Access to Mifepristone (general); Contraception (general); Maternal Mortality and Morbidity (general); H.R. 1117, Advancing Safe Medications for Moms and Babies Act; obstetric and gynecologic care in rural areas (general; H.R. 3305/S. 1606, Black Maternal Health Momnibus Act; H.R. 952, Kids Access to Primary Care Act of 2023; H.R. 1202/S. 704, Resident Education Deferred Interest (REDI) Act; H.R. 4933/S. 462, Mental Health Professionals Workforce Shortage Loan Repayment Act of 2023; H.R. 2389/S. 1302, Resident Physician Shortage Reduction Act of 2023; H.R. 2569, Doctors of Community (DOC) Act; Teaching Health Center Graduate Medication Education (general); physician workforce and training (general); H.R. 3838/S. 2415, Preventing Maternal Deaths Reauthorization Act of 2023; H.R. 3226/S. 1573, PREEMIE Reauthorization Act of 2023; inclusion of pregnant and lactating individuals in research (general); Implementation of P.L. 115-320, Improving Access to Maternity Care Act; telemedicine (general); H.R. 5012/S. 2647, SHINE for Autumn Act; Rural Residency Planning and Development (RRPD) Program; H.R. 4581/S. 2231, Maternal and Child Health Stillbirth Prevention Act; Implementation of P.L. 117-328, Consolidated Appropriations Act, including the Pregnant Workers Fairness Act; Health Insurance Portability and Accountability Act (general); patient-physician relationship (general); H.R. 4605/S. 948, Healthy Moms and Babies Act; H.R. 4816/S. 2427, Convenient Contraception Act; Cost-sharing for maternity care (general); H.R. 4796/S. 2439, Reproductive Health Patient Navigator Act; H.R. 4731/S. 2386, Access to Infertility Treatment and Care Act; H.R. 5066, Tech to Save Moms Act; H.R. 4901/S. 2544, Reproductive Health Care Accessibility Act; Conscientious refusals in medicine (general); H.R. 834/S. 230, Rural Physician Workforce Production Act; menopause research (general); Alliance for Innovation on Maternal Health; Residency programs in obstetrics and gynecology (general); H.R. 5568/S. 2846, CARE for Moms Act; Value-based care models for obstetrics and gynecology (general); S. 3006, SAFE in Recovery Act; H.R. 4775, Helping Tobacco Users Quit Act; Treatment of reproductive health information under the Stored Communications Act (general); Congenital syphilis (general); Tax treatment of stillbirths (general); Substance use disorder during pregnancy (general); H.R. 117, NEWBORN Act; Physician burnout (general); Maternal mental health (general).

Expand Patient Access and Telehealth: Urged Congress to support several bills to expand patient access to medical coverage. ACP supports H.R. 1114, the Long COVID Response is Care Optimized and Vitally Essential Resources that Yield New Opportunities for Wellness Act or the Long COVID RECOVERY NOW Act, which would optimize care by enhancing a coordinated federal government response, public education and insurance reimbursement guidance for Long COVID. H.R. 1114 would also authorize the Secretary of Health and Human Services to provide grants to primary care practices to facilitate the adoption of evidence-based Long COVID clinical practices that have been demonstrated to improve the wellness of individuals with Long COVJD and submission of data to HHS on the characteristics, diagnoses, and health care service utilization of Long COVID patients. Urged Congress to pass H.R. 952, the Kids Access to Primary Care Act, which ensures that Medicaid payment rates for primary care services are equal to Medicare rates. The ACA included a provision that required states to raise Medicaid payment rates for primary care services equal to Medicare rates in 2013 and 2014 but this provision expired after those two years and was not renewed by Congress. Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported H.R. 2829, the Chronic Care Management Improvement Act of 2023, that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported Black Maternal Health Momnibus Act, H.R. 3305 and S. 1606, to improve maternal health, particularly among racial and ethnic minority groups, veterans, and other vulnerable populations. It also addresses maternal health issues related to COVID-19. The Department of Health and Human Services (HHS) and other specified departments would address the social determinants of maternal health, which include childcare, housing, food security, transportation, and environmental conditions. The bill also extends to 24 months postpartum eligibility for the Special Supplemental Nutrition Program for Woman, Infants, and Children. Additionally, HHS and other agencies must take actions to grow and diversify the maternal health workforce. To increase access to maternity care, HHS and other agencies must 1) award specified grants; 2) test an alternative payment model for perinatal care under Medicaid and the Children's Health Insurance Program (CHIP); and 3) support training, technology, and telehealth initiatives. Supported the Public Health Infrastructure Saves Lives Act, S. 1995, that provides annual funding for the CDC to strengthen core public health infrastructure. Core public health infrastructure includes the elements and workforce capabilities that enable health departments to perform critical functions such as disease surveillance and emergency response. Specifically, the CDC must award grants to health departments for their core infrastructure needs. In addition, the CDC must support the development of accreditation standards for health departments that emphasize core public health infrastructure. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Supporting those provisions in the 2023 Farm Bill, the 5-year reauthorization legislation, related to food and nutrition - namely food security and Supplemental Nutrition Assistance Program (SNAP) provisions. We support the nutrition assistance and food distribution programs for nearly 40 million people with low-income, e.g. ((SNAP Supplemental Nutrition Assistance Program, The Emergency Food Assistance Program (TEFAP) and preserving the current SNAP entitlement and funding structure to ensure benefit adequacy without work requirements. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 2001 to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Supported H.R. 6545, the Physician Fee Schedule Update and Improvements Act before the House Energy and Commerce Committee. This bill includes an important provision that would allocate 3 percent to the 2024 Medicare conversion factor, which would represent a 1.75 percent increase to the approved level. H.R. 6545 also includes several provisions from H.R. 6371, the Provider Reimbursement Stability Act of 2023, that ACP supports. It would raise the budget neutrality threshold to $53 million and would use cumulative increases in the Medicare Economic Index (MEI) to update the threshold every five years afterwards. Supported H.R. 6683, the Preserving Seniors Access to Physicians Act of 2023. That bill averts a 3.4 percent across-the-board cut to physician payment for 2024. ACP supported extending the work geographic practice costs index to improve the accuracy of geographic adjustment factors. Supported H.R. 6366 that would extend the work geographic practice costs index for another year to 1.00 for any locality where the index would be less than 1.00. G2211 Add on Code Implementation: Urged Congress to support the full implementation of a Medicare add-on code, known as G2211, in 2024. This code will improve Medicare beneficiaries access to high-quality, continuous care and help sustain the physician practices beneficiaries rely on for comprehensive health care. G2211 would be billed alongside codes for office/outpatient evaluation and management (E/M) visits to better account for the unique and inherent complexity of services provided through longitudinal patient care that is based on a clinicians ongoing relationship with a patient and is related to a patients single, serious condition or a complex condition. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. ACP supports extending incentive payments for participation in eligible alternative payment models through 2026. This approach would help to maintain incentives that support physicians transition from a volume-based fee-for-service health care system to one that is based on the value and quality outcomes of health care delivered to the patient. Supported H.R. 6369 by Rep. Kim Schrier to extend incentive payments for participation in eligible alternative payment models. ACP supports H.R. 5395, the SURS Extension Act, which would extend the Quality Payment Program-Small Practice, Underserved, and Rural Support (QPP-SURS) program for fiscal years 2024-2029. This program was established under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and has provided direct assistance to eligible clinicians required to participate in MIPS. ACP supports efforts to streamline the number of quality measures physicians must report on and enhance stakeholder engagement. Supported the Fewer Burdens for Better Care Act of 2023, which would emphasize multi-stakeholder input, with a 30-day comment period for stakeholders to comment on the removal of measures from the Medicare program. MACRA Reform Hearings: We requested Congressional hearings on The Medicare Access and CHIP Reauthorization Act (MACRA) to focus upon whether the current system achieves the Congressional intent to move towards value- based care and to consider the long-term viability of the current Medicare physician payment system. These hearings should focus on the characteristics of a rational Medicare payment system. This should include: 1) positive consistent and stable annual payment updates that offer the financial stability needed for our physicians to transition their practices to value-based payment models; 2) meaningful and actionable quality reporting initiatives that adequately measure the quality of care our physicians provide to their patients; and 3) a sufficient number of Advanced APMs for our physicians to join to provide high quality value-based care to their patients. Pricing Transparency/Consolidation: Supported several provisions of H.R. 5378, Lower Costs, More Transparency Act, which are consistent with our policy and would improve access to and affordability of health care for patients. This bill brings together H.R. 4822, Health Care Price Transparency Act of 2023, H.R. 3561, Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023 and other related bills reported out of Ways and Means, Energy and Commerce and Education and Workforce Committees. Supported requiring disclosure of changes in hospital or health facility ownership to reveal when private equity firms acquire hospitals, larger physician practices or nursing homes, promote price transparency among hospitals, health plans and pharmacy benefit managers and promote site neutrality for Medicare and Medicare beneficiaries. We further supported the reauthorization and funding increases included for the Teaching Health Center Graduate Medical Education program, Community Health Center program and National Health Service Corps. Supported Section 4 of H.R. 2880, the Protecting Patients Against PBM Abuses Act, which aims to increase PBM data reporting to enhance transparency for Medicare Part D. Specifically, it would set out new requirements for PBMs to report data on rebates and administrative fees to HHS. It would also require that HHS deidentify the data and make it publicly available so that policy makers and the public will have a better understanding of how rebates and administrative fees impact the costs of drug plans. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes. Advocated against a March 2023 ruling by a federal judge in Texas that the ACA's requirements for coverage for preventive services will harm the health of Americans. Previously, under the ACA, health insurance plans have been required to include coverage at no cost to patients for preventive services recommended by the U.S. Preventive Services Task Force. These preventive services include cancer screenings, mental health screenings, heart disease and hypertension screenings, among other services. Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. FY2024 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vil, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include at least $11.581 billion for the CDC's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies appropriations bill. Submitted FY2024 report language to Congress regarding the overestimation of utilization of new codes. Supported $60 million for Public Health Infrastructure and Capacity, $400 million for Title X Family Service Grants, and $35 million for CDC Firearm Injury Prevention and Control. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S. 323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Supported H.R.4986/S. 2577, which would refinance the interest rate for all existing federal student loans to zero percent. Further, it would cap interest rates for future student loan borrowers, while considering their financial needs. Prescription Drug Reform: Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Supported H.R. 4895, the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029. Supported H.R. 5385, the Medicare PBM Accountability Act. This legislation aims to lower the costs of prescription drugs for seniors covered by Medicare Part D and Medicare Advantage plans. It would require PBMs to submit annual reports to the Secretary of HHS on PBMs cost savings incurred from rebates, discounts, and price concessions. Supported H.R. 1352, the Increasing Access to Biosimilars Act of 2023. This legislation would encourage adoption of biosimilars in Medicare and improve biosimilar accessibility, by establishing a new pilot program - a voluntary, shared savings demonstration program - for providers of biosimilars in Medicare Part B. Supported H.R. 5386, the Cutting Copays Act. This legislation would eliminate cost-sharing for generic drugs for LIS beneficiaries, helping to incentivize the use of generic drugs. Supported H.R. 3009/S. 2362, the Drug Shortage Prevention Act of 2023, to require that manufacturers of over-the-counter and prescription drugs notify Food & Drug Administration when they are unlikely to meet demand. Social Determinants of Healthcare: Urged Congress to support legislation to expand utilization of social determinants of healthcare to expand governments capabilities to provide healthcare to underserved and disadvantaged communities. Supported the Improving the Social Determinants of Health Act of 2023 that would: award grants to state, local, territorial, and Tribal health agencies and organizations to address SDOHs in target communities; award grants to nonprofit organizations and institutions of higher education to conduct research on SDOH best practices; provide technical assistance, training, and evaluation assistance to target community grantees; and disseminate best practices; and collect and analyze data related to SDOH activities. Supported Donald McEachin Environmental Justice for All Act, H.R. 1705 and S. 1606. The bill contains environmental justice requirements, advisory bodies, and programs to address the disproportionate adverse human health or environmental effects of federal laws or programs on communities of color, low-income communities, or tribal and indigenous communities. Specifically, the bill prohibits disparate impacts on the basis of race, color, or national origin as discrimination. Aggrieved persons may seek legal remedy when faced with such discrimination. In addition, the bill directs agencies to follow certain requirements concerning environmental justice. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 2I and be subject to a criminal background check. Urged Congress to support the Bipartisan Background Checks Act, H.R. 715, and the Background Check Expansion Act, S. 494 and Ethans Law, H.R. 660 and S. 173, requiring gun owners to safely and securely store their firearms. Supported the Keep Americans Safe Act, H.R. 625 and S. 298, which would ban the importation, sale, manufacture, transfer, or possession of high-capacity gun magazines that hold more than fifteen rounds. Supported the Extreme Risk Protection Order Expansion Act, H.R. 768 and S. 247 empowering family members and law enforcement to prevent gun violence by petitioning a court to temporarily separate an at-risk individual from firearms. Supported the FY2024 funding gun violence prevention research contained in FY24 Senate Labor-HHS-Ed appropriations bill for inclusion in any final FY24 appropriations bills. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors' Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols Mental and Behavioral Health: Urged members of Congress to cosponsor and reintroduces H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs. Supported S. 1378, the Connecting Our Medic

Expand Patient Access and Telehealth: Urged Congress to support several bills to expand patient access to medical coverage. ACP supports H.R. 1114, the Long COVID Response is Care Optimized and Vitally Essential Resources that Yield New Opportunities for Wellness Act or the Long COVID RECOVERY NOW Act, which would optimize care by enhancing a coordinated federal government response, public education and insurance reimbursement guidance for Long COVID. H.R. 1114 would also authorize the Secretary of Health and Human Services to provide grants to primary care practices to facilitate the adoption of evidence-based Long COVID clinical practices that have been demonstrated to improve the wellness of individuals with Long COVJD and submission of data to HHS on the characteristics, diagnoses, and health care service utilization of Long COVID patients. Urged Congress to pass H.R. 952, the Kids Access to Primary Care Act, which ensures that Medicaid payment rates for primary care services are equal to Medicare rates. The ACA included a provision that required states to raise Medicaid payment rates for primary care services equal to Medicare rates in 2013 and 2014 but this provision expired after those two years and was not renewed by Congress. Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported H.R. 2829, the Chronic Care Management Improvement Act of 2023, that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported Black Maternal Health Momnibus Act, H.R. 3305 and S. 1606, to improve maternal health, particularly among racial and ethnic minority groups, veterans, and other vulnerable populations. It also addresses maternal health issues related to COVID-19. The Department of Health and Human Services (HHS) and other specified departments would address the social determinants of maternal health, which include childcare, housing, food security, transportation, and environmental conditions. The bill also extends to 24 months postpartum eligibility for the Special Supplemental Nutrition Program for Woman, Infants, and Children. Additionally, HHS and other agencies must take actions to grow and diversify the maternal health workforce. To increase access to maternity care, HHS and other agencies must 1) award specified grants; 2) test an alternative payment model for perinatal care under Medicaid and the Children's Health Insurance Program (CHIP); and 3) support training, technology, and telehealth initiatives. Supported the Public Health Infrastructure Saves Lives Act, S. 1995, that provides annual funding for the CDC to strengthen core public health infrastructure. Core public health infrastructure includes the elements and workforce capabilities that enable health departments to perform critical functions such as disease surveillance and emergency response. Specifically, the CDC must award grants to health departments for their core infrastructure needs. In addition, the CDC must support the development of accreditation standards for health departments that emphasize core public health infrastructure. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Supporting those provisions in the 2023 Farm Bill, the 5-year reauthorization legislation, related to food and nutrition - namely food security and Supplemental Nutrition Assistance Program (SNAP) provisions. We support the nutrition assistance and food distribution programs for nearly 40 million people with low-income, e.g. ((SNAP Supplemental Nutrition Assistance Program, The Emergency Food Assistance Program (TEFAP) and preserving the current SNAP entitlement and funding structure to ensure benefit adequacy without work requirements. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 2001 to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Supported H.R. 6545, the Physician Fee Schedule Update and Improvements Act before the House Energy and Commerce Committee. This bill includes an important provision that would allocate 3 percent to the 2024 Medicare conversion factor, which would represent a 1.75 percent increase to the approved level. H.R. 6545 also includes several provisions from H.R. 6371, the Provider Reimbursement Stability Act of 2023, that ACP supports. It would raise the budget neutrality threshold to $53 million and would use cumulative increases in the Medicare Economic Index (MEI) to update the threshold every five years afterwards. Supported H.R. 6683, the Preserving Seniors Access to Physicians Act of 2023. That bill averts a 3.4 percent across-the-board cut to physician payment for 2024. ACP supported extending the work geographic practice costs index to improve the accuracy of geographic adjustment factors. Supported H.R. 6366 that would extend the work geographic practice costs index for another year to 1.00 for any locality where the index would be less than 1.00. G2211 Add on Code Implementation: Urged Congress to support the full implementation of a Medicare add-on code, known as G2211, in 2024. This code will improve Medicare beneficiaries access to high-quality, continuous care and help sustain the physician practices beneficiaries rely on for comprehensive health care. G2211 would be billed alongside codes for office/outpatient evaluation and management (E/M) visits to better account for the unique and inherent complexity of services provided through longitudinal patient care that is based on a clinicians ongoing relationship with a patient and is related to a patients single, serious condition or a complex condition. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. ACP supports extending incentive payments for participation in eligible alternative payment models through 2026. This approach would help to maintain incentives that support physicians transition from a volume-based fee-for-service health care system to one that is based on the value and quality outcomes of health care delivered to the patient. Supported H.R. 6369 by Rep. Kim Schrier to extend incentive payments for participation in eligible alternative payment models. ACP supports H.R. 5395, the SURS Extension Act, which would extend the Quality Payment Program-Small Practice, Underserved, and Rural Support (QPP-SURS) program for fiscal years 2024-2029. This program was established under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and has provided direct assistance to eligible clinicians required to participate in MIPS. ACP supports efforts to streamline the number of quality measures physicians must report on and enhance stakeholder engagement. Supported the Fewer Burdens for Better Care Act of 2023, which would emphasize multi-stakeholder input, with a 30-day comment period for stakeholders to comment on the removal of measures from the Medicare program. MACRA Reform Hearings: We requested Congressional hearings on The Medicare Access and CHIP Reauthorization Act (MACRA) to focus upon whether the current system achieves the Congressional intent to move towards value- based care and to consider the long-term viability of the current Medicare physician payment system. These hearings should focus on the characteristics of a rational Medicare payment system. This should include: 1) positive consistent and stable annual payment updates that offer the financial stability needed for our physicians to transition their practices to value-based payment models; 2) meaningful and actionable quality reporting initiatives that adequately measure the quality of care our physicians provide to their patients; and 3) a sufficient number of Advanced APMs for our physicians to join to provide high quality value-based care to their patients. Pricing Transparency/Consolidation: Supported several provisions of H.R. 5378, Lower Costs, More Transparency Act, which are consistent with our policy and would improve access to and affordability of health care for patients. This bill brings together H.R. 4822, Health Care Price Transparency Act of 2023, H.R. 3561, Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023 and other related bills reported out of Ways and Means, Energy and Commerce and Education and Workforce Committees. Supported requiring disclosure of changes in hospital or health facility ownership to reveal when private equity firms acquire hospitals, larger physician practices or nursing homes, promote price transparency among hospitals, health plans and pharmacy benefit managers and promote site neutrality for Medicare and Medicare beneficiaries. We further supported the reauthorization and funding increases included for the Teaching Health Center Graduate Medical Education program, Community Health Center program and National Health Service Corps. Supported Section 4 of H.R. 2880, the Protecting Patients Against PBM Abuses Act, which aims to increase PBM data reporting to enhance transparency for Medicare Part D. Specifically, it would set out new requirements for PBMs to report data on rebates and administrative fees to HHS. It would also require that HHS deidentify the data and make it publicly available so that policy makers and the public will have a better understanding of how rebates and administrative fees impact the costs of drug plans. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes. Advocated against a March 2023 ruling by a federal judge in Texas that the ACA's requirements for coverage for preventive services will harm the health of Americans. Previously, under the ACA, health insurance plans have been required to include coverage at no cost to patients for preventive services recommended by the U.S. Preventive Services Task Force. These preventive services include cancer screenings, mental health screenings, heart disease and hypertension screenings, among other services. Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. FY2024 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vil, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include at least $11.581 billion for the CDC's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies appropriations bill. Submitted FY2024 report language to Congress regarding the overestimation of utilization of new codes. Supported $60 million for Public Health Infrastructure and Capacity, $400 million for Title X Family Service Grants, and $35 million for CDC Firearm Injury Prevention and Control. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S. 323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Supported H.R.4986/S. 2577, which would refinance the interest rate for all existing federal student loans to zero percent. Further, it would cap interest rates for future student loan borrowers, while considering their financial needs. Prescription Drug Reform: Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Supported H.R. 4895, the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029. Supported H.R. 5385, the Medicare PBM Accountability Act. This legislation aims to lower the costs of prescription drugs for seniors covered by Medicare Part D and Medicare Advantage plans. It would require PBMs to submit annual reports to the Secretary of HHS on PBMs cost savings incurred from rebates, discounts, and price concessions. Supported H.R. 1352, the Increasing Access to Biosimilars Act of 2023. This legislation would encourage adoption of biosimilars in Medicare and improve biosimilar accessibility, by establishing a new pilot program - a voluntary, shared savings demonstration program - for providers of biosimilars in Medicare Part B. Supported H.R. 5386, the Cutting Copays Act. This legislation would eliminate cost-sharing for generic drugs for LIS beneficiaries, helping to incentivize the use of generic drugs. Supported H.R. 3009/S. 2362, the Drug Shortage Prevention Act of 2023, to require that manufacturers of over-the-counter and prescription drugs notify Food & Drug Administration when they are unlikely to meet demand. Social Determinants of Healthcare: Urged Congress to support legislation to expand utilization of social determinants of healthcare to expand governments capabilities to provide healthcare to underserved and disadvantaged communities. Supported the Improving the Social Determinants of Health Act of 2023 that would: award grants to state, local, territorial, and Tribal health agencies and organizations to address SDOHs in target communities; award grants to nonprofit organizations and institutions of higher education to conduct research on SDOH best practices; provide technical assistance, training, and evaluation assistance to target community grantees; and disseminate best practices; and collect and analyze data related to SDOH activities. Supported Donald McEachin Environmental Justice for All Act, H.R. 1705 and S. 1606. The bill contains environmental justice requirements, advisory bodies, and programs to address the disproportionate adverse human health or environmental effects of federal laws or programs on communities of color, low-income communities, or tribal and indigenous communities. Specifically, the bill prohibits disparate impacts on the basis of race, color, or national origin as discrimination. Aggrieved persons may seek legal remedy when faced with such discrimination. In addition, the bill directs agencies to follow certain requirements concerning environmental justice. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 2I and be subject to a criminal background check. Urged Congress to support the Bipartisan Background Checks Act, H.R. 715, and the Background Check Expansion Act, S. 494 and Ethans Law, H.R. 660 and S. 173, requiring gun owners to safely and securely store their firearms. Supported the Keep Americans Safe Act, H.R. 625 and S. 298, which would ban the importation, sale, manufacture, transfer, or possession of high-capacity gun magazines that hold more than fifteen rounds. Supported the Extreme Risk Protection Order Expansion Act, H.R. 768 and S. 247 empowering family members and law enforcement to prevent gun violence by petitioning a court to temporarily separate an at-risk individual from firearms. Supported the FY2024 funding gun violence prevention research contained in FY24 Senate Labor-HHS-Ed appropriations bill for inclusion in any final FY24 appropriations bills. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors' Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols Mental and Behavioral Health: Urged members of Congress to cosponsor and reintroduces H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs. Supported S. 1378, the Connecting Our Medic

No Bill No. - Congressional Primary Care Caucus No Bill No. - Black Maternal Health Momnibus Act No Bill No. - Medicare Physician Payment Reform No Bill No. - MACRA Implementation No Bill No. - CY2024 Medicare Physician Fee Schedule No Bill No. - CY 2024 Medicare Inpatient Prospective Payment System No Bill No. - Site Neutrality and Consolidation No Bill No. - CMS Prior Authorization Rules No Bill No. - Tobacco Users Quiet Act No Bill No. - G2211 Code (Physician Fee Schedule) No Bill No. - Reducing Medically Unnecessary Delays in Care Act (H.R. 952) Kids Access to Primary Care Act (H.R. 2400/S. 1165) The Reentry Act (H.R. 3074) Due Process Continuity of Care Act (H.R. 3766) Extending Access to Addiction Treatment Act (H.R. 4950/S. 2841) Improve Addiction Care Act (H.R. 4771) Children's Health Insurance Program Permanency Act (H.R. 4968) GOLD Card Act of 2023 (S. 2556) Improving Care for Youth Act (H.R. 5013) Value in Health Care Act (S. 2816) Medicaid for Every Child Act (H.R. 6545) Physician Fee Schedule Update and Improvements Act (H.R. 5434/S.3138) Stabilize Medicaid and CHIP Coverage Act (H.R. 5395) SURS Extension Act

Client expense: $816,759 · Firm income: Not reported

Abortion access (general); Access to Mifepristone (general); Contraception (general); Maternal Mortality and Morbidity (general); H.R. 1117, Advancing Safe Medications for Moms and Babies Act; obstetric and gynecologic care in rural areas (general; H.R. 3305/S. 1606, Black Maternal Health Momnibus Act; H.R. 952, Kids Access to Primary Care Act of 2023; H.R. 1202/S. 704, Resident Education Deferred Interest (REDI) Act; H.R. 4933/S. 462, Mental Health Professionals Workforce Shortage Loan Repayment Act of 2023; H.R. 2389/S. 1302, Resident Physician Shortage Reduction Act of 2023; H.R. 2569, Doctors of Community (DOC) Act; Teaching Health Center Graduate Medication Education (general); physician workforce and training (general); H.R. 3838/S. 2415, Preventing Maternal Deaths Reauthorization Act of 2023; H.R. 3226/S. 1573, PREEMIE Reauthorization Act of 2023; inclusion of pregnant and lactating individuals in research (general); Implementation of P.L. 115-320, Improving Access to Maternity Care Act; telemedicine (general); H.R. 5012/S. 2647, SHINE for Autumn Act; Rural Residency Planning and Development (RRPD) Program; H.R. 4581/S. 2231, Maternal and Child Health Stillbirth Prevention Act; Implementation of P.L. 117-328, Consolidated Appropriations Act, including the Pregnant Workers Fairness Act; Health Insurance Portability and Accountability Act (general); patient-physician relationship (general); H.R. 4605/S. 948, Healthy Moms and Babies Act; H.R. 4816/S. 2427, Convenient Contraception Act; Cost-sharing for maternity care (general); H.R. 4796/S. 2439, Reproductive Health Patient Navigator Act; H.R. 4731/S. 2386, Access to Infertility Treatment and Care Act; H.R. 5066, Tech to Save Moms Act; H.R. 4901/S. 2544, Reproductive Health Care Accessibility Act; Conscientious refusals in medicine (general); H.R. 834/S. 230, Rural Physician Workforce Production Act; menopause research (general); Alliance for Innovation on Maternal Health; Residency programs in obstetrics and gynecology (general); H.R. 5568/S. 2846, CARE for Moms Act; Value-based care models for obstetrics and gynecology (general); S. 3006, SAFE in Recovery Act; H.R. 4775, Helping Tobacco Users Quit Act; Treatment of reproductive health information under the Stored Communications Act (general); Congenital syphilis (general); Tax treatment of stillbirths (general); Substance use disorder during pregnancy (general); H.R. 117, NEWBORN Act; Physician burnout (general); Maternal mental health (general).

No Bill No. - Congressional Primary Care Caucus No Bill No. - Black Maternal Health Momnibus Act No Bill No. - Medicare Physician Payment Reform No Bill No. - MACRA Implementation No Bill No. - CY2024 Medicare Physician Fee Schedule No Bill No. - CY 2024 Medicare Inpatient Prospective Payment System No Bill No. - Site Neutrality and Consolidation No Bill No. - CMS Prior Authorization Rules No Bill No. - Tobacco Users Quiet Act No Bill No. - G2211 Code (Physician Fee Schedule) No Bill No. - Reducing Medically Unnecessary Delays in Care Act (H.R. 952) Kids Access to Primary Care Act (H.R. 2400/S. 1165) The Reentry Act (H.R. 3074) Due Process Continuity of Care Act (H.R. 3766) Extending Access to Addiction Treatment Act (H.R. 4950/S. 2841) Improve Addiction Care Act (H.R. 4771) Children's Health Insurance Program Permanency Act (H.R. 4968) GOLD Card Act of 2023 (S. 2556) Improving Care for Youth Act (H.R. 5013) Value in Health Care Act

Client expense: $786,279 · Firm income: Not reported

No Bill No. - Congressional Primary Care Caucus No Bill No. - Black Maternal Health Momnibus Act No Bill No. - Medicare Physician Payment Reform No Bill No. - MACRA Implementation No Bill No. - CY2024 Medicare Physician Fee Schedule No Bill No. - CY 2024 Medicare Inpatient Prospective Payment System No Bill No. - Site Neutrality and Consolidation No Bill No. - CMS Prior Authorization Rules No Bill No. - Tobacco Users Quiet Act No Bill No. - G2211 Code (Physician Fee Schedule) No Bill No. - Reducing Medically Unnecessary Delays in Care Act (H.R. 952) Kids Access to Primary Care Act (H.R. 2400/S. 1165) The Reentry Act (H.R. 3074) Due Process Continuity of Care Act (H.R. 3766) Extending Access to Addiction Treatment Act (H.R. 4950/S. 2841) Improve Addiction Care Act (H.R. 4771) Children's Health Insurance Program Permanency Act (H.R. 4968) GOLD Card Act of 2023 (S. 2556) Improving Care for Youth Act (H.R. 5013) Value in Health Care Act

Client expense: $786,279 · Firm income: Not reported

Expand Patient Access and Telehealth: Urged Congress to support several bills to expand patient access to medical coverage. ACP supports H.R. 1114, the Long COVID Response is Care Optimized and Vitally Essential Resources that Yield New Opportunities for Wellness Act or the Long COVID RECOVERY NOW Act, which would optimize care by enhancing a coordinated federal government response, public education and insurance reimbursement guidance for Long COVID. H.R. 1114 would also authorize the Secretary of Health and Human Services to provide grants to primary care practices to facilitate the adoption of evidence-based Long COVID clinical practices that have been demonstrated to improve the wellness of individuals with Long COVJD and submission of data to HHS on the characteristics, diagnoses, and health care service utilization of Long COVID patients. Urged Congress to pass H.R. 952, the Kids Access to Primary Care Act, which ensures that Medicaid payment rates for primary care services are equal to Medicare rates. The ACA included a provision that required states to raise Medicaid payment rates for primary care services equal to Medicare rates in 2013 and 2014 but this provision expired after those two years and was not renewed by Congress. Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported H.R. 2829, the Chronic Care Management Improvement Act of 2023, that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported Black Maternal Health Momnibus Act, H.R. 3305 and S. 1606, to improve maternal health, particularly among racial and ethnic minority groups, veterans, and other vulnerable populations. It also addresses maternal health issues related to COVID-19. The Department of Health and Human Services (HHS) and other specified departments would address the social determinants of maternal health, which include childcare, housing, food security, transportation, and environmental conditions. The bill also extends to 24 months postpartum eligibility for the Special Supplemental Nutrition Program for Woman, Infants, and Children. Additionally, HHS and other agencies must take actions to grow and diversify the maternal health workforce. To increase access to maternity care, HHS and other agencies must 1) award specified grants; 2) test an alternative payment model for perinatal care under Medicaid and the Children's Health Insurance Program (CHIP); and 3) support training, technology, and telehealth initiatives. Supported the Public Health Infrastructure Saves Lives Act, S. 1995, that provides annual funding for the CDC to strengthen core public health infrastructure. Core public health infrastructure includes the elements and workforce capabilities that enable health departments to perform critical functions such as disease surveillance and emergency response. Specifically, the CDC must award grants to health departments for their core infrastructure needs. In addition, the CDC must support the development of accreditation standards for health departments that emphasize core public health infrastructure. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Supporting those provisions in the 2023 Farm Bill, the 5-year reauthorization legislation, related to food and nutrition - namely food security and Supplemental Nutrition Assistance Program (SNAP) provisions. We support the nutrition assistance and food distribution programs for nearly 40 million people with low-income, e.g. ((SNAP Supplemental Nutrition Assistance Program, The Emergency Food Assistance Program (TEFAP) and preserving the current SNAP entitlement and funding structure to ensure benefit adequacy without work requirements. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 200 I to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. G2211 Add on Code Implementation: ACP urged Congress to support the full implementation of a Medicare add-on code, known as G2211, in 2024. This code will improve Medicare beneficiaries access to high-quality, continuous care and help sustain the physician practices beneficiaries rely on for comprehensive health care. G2211 would be billed alongside codes for office/outpatient evaluation and management (E/M) visits to better account for the unique and inherent complexity of services provided through longitudinal patient care that is based on a clinicians ongoing relationship with a patient and is related to a patients single, serious condition or a complex condition. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. MACRA Reform Hearings: We requested Congressional hearings on The Medicare Access and CHIP Reauthorization Act (MACRA) to focus upon whether the current system achieves the Congressional intent to move towards value- based care and to consider the long-term viability of the current Medicare physician payment system. These hearings should focus on the characteristics of a rational Medicare payment system. This should include: 1) Positive consistent and stable annual payment updates that offer the financial stability needed for our physicians to transition their practices to value-based payment models; 2) Meaningful and actionable quality reporting initiatives that adequately measure the quality of care our physicians provide to their patients; AND 3) A sufficient number of Advanced APMs for our physicians to join to provide high quality value-based care to their patients. Pricing Transparency/Consolidation: Supported several provisions of H.R. 5378, Lower Costs, More Transparency Act, which are consistent with our policy and would improve access to and affordability of health care for patients. This bill brings together H.R. 4822, Health Care Price Transparency Act of 2023, H.R. 3561, Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023 and other related bills reported out of Ways and Means, Energy and Commerce and Education and Workforce Committees. Supported requiring disclosure of changes in hospital or health facility ownership to reveal when private equity firms acquire hospitals, larger physician practices or nursing homes, promote price transparency among hospitals, health plans and pharmacy benefit managers and promote site neutrality for Medicare and Medicare beneficiaries. We further supported the reauthorization and funding increases included for the Teaching Health Center Graduate Medical Education program, Community Health Center program and National Health Service Corps. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes. Advocated against a March 2023 ruling by a federal judge in Texas that the ACA's requirements for coverage for preventive services will harm the health of Americans. Previously, under the ACA, health insurance plans have been required to include coverage at no cost to patients for preventive services recommended by the U.S. Preventive Services Task Force. These preventive services include cancer screenings, mental health screenings, heart disease and hypertension screenings, among other services. Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. FY2024 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vil, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include at least $11.581 billion for the CDC's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies appropriations bill. Submitted FY2024 report language to Congress regarding the overestimation of utilization of new codes. Supported $60 million for Public Health Infrastructure and Capacity, $400 million for Title X Family Service Grants, and $35 million for CDC Firearm Injury Prevention and Control. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S. 323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Prescription Drug Reform: Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Supported H.R. 4895, the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029. Social Determinants of Healthcare: Urged Congress to support legislation to expand utilization of social determinants of healthcare to expand governments capabilities to provide healthcare to underserved and disadvantaged communities. Supported the Improving the Social Determinants of Health Act of 2023 that would: award grants to state, local, territorial, and Tribal health agencies and organizations to address SDOHs in target communities; award grants to nonprofit organizations and institutions of higher education to conduct research on SDOH best practices; provide technical assistance, training, and evaluation assistance to target community grantees; and disseminate best practices; and collect and analyze data related to SDOH activities. Supported Donald McEachin Environmental Justice for All Act, H.R. 1705 and S. 1606. The bill contains environmental justice requirements, advisory bodies, and programs to address the disproportionate adverse human health or environmental effects of federal laws or programs on communities of color, low-income communities, or tribal and indigenous communities. Specifically, the bill prohibits disparate impacts on the basis of race, color, or national origin as discrimination. Aggrieved persons may seek legal remedy when faced with such discrimination. In addition, the bill directs agencies to follow certain requirements concerning environmental justice. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 2I and be subject to a criminal background check. Urged Congress to support the Bipartisan Background Checks Act, H.R. 715, and the Background Check Expansion Act, S. 494 and Ethans Law, H.R. 660 and S. 173, requiring gun owners to safely and securely store their firearms. Supported the Keep Americans Safe Act, H.R. 625 and S. 298, which would ban the importation, sale, manufacture, transfer, or possession of high-capacity gun magazines that hold more than fifteen rounds. Supported the Extreme Risk Protection Order Expansion Act, H.R. 768 and S. 247 empowering family members and law enforcement to prevent gun violence by petitioning a court to temporarily separate an at-risk individual from firearms. We supported the FY2024 funding gun violence prevention research contained in FY24 Senate Labor-HHS-Ed appropriations bill for inclusion in any final FY24 appropriations bills. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors' Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Mental and Behavioral Health: Urged members of Congress to cosponsor and reintroduces H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs. Supported S. 1378, the Connecting Our Medical Providers with Links to Expand Tailored and Effective Care or the COMPLETE Care Act, to improve the integration of behavioral health in primary care practices.

Expand Patient Access and Telehealth: Urged Congress to support several bills to expand patient access to medical coverage. ACP supports H.R. 1114, the Long COVID Response is Care Optimized and Vitally Essential Resources that Yield New Opportunities for Wellness Act or the Long COVID RECOVERY NOW Act, which would optimize care by enhancing a coordinated federal government response, public education and insurance reimbursement guidance for Long COVID. H.R. 1114 would also authorize the Secretary of Health and Human Services to provide grants to primary care practices to facilitate the adoption of evidence-based Long COVID clinical practices that have been demonstrated to improve the wellness of individuals with Long COVJD and submission of data to HHS on the characteristics, diagnoses, and health care service utilization of Long COVID patients. Urged Congress to pass H.R. 952, the Kids Access to Primary Care Act, which ensures that Medicaid payment rates for primary care services are equal to Medicare rates. The ACA included a provision that required states to raise Medicaid payment rates for primary care services equal to Medicare rates in 2013 and 2014 but this provision expired after those two years and was not renewed by Congress. Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported H.R. 2829, the Chronic Care Management Improvement Act of 2023, that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported Black Maternal Health Momnibus Act, H.R. 3305 and S. 1606, to improve maternal health, particularly among racial and ethnic minority groups, veterans, and other vulnerable populations. It also addresses maternal health issues related to COVID-19. The Department of Health and Human Services (HHS) and other specified departments would address the social determinants of maternal health, which include childcare, housing, food security, transportation, and environmental conditions. The bill also extends to 24 months postpartum eligibility for the Special Supplemental Nutrition Program for Woman, Infants, and Children. Additionally, HHS and other agencies must take actions to grow and diversify the maternal health workforce. To increase access to maternity care, HHS and other agencies must 1) award specified grants; 2) test an alternative payment model for perinatal care under Medicaid and the Children's Health Insurance Program (CHIP); and 3) support training, technology, and telehealth initiatives. Supported the Public Health Infrastructure Saves Lives Act, S. 1995, that provides annual funding for the CDC to strengthen core public health infrastructure. Core public health infrastructure includes the elements and workforce capabilities that enable health departments to perform critical functions such as disease surveillance and emergency response. Specifically, the CDC must award grants to health departments for their core infrastructure needs. In addition, the CDC must support the development of accreditation standards for health departments that emphasize core public health infrastructure. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Supporting those provisions in the 2023 Farm Bill, the 5-year reauthorization legislation, related to food and nutrition - namely food security and Supplemental Nutrition Assistance Program (SNAP) provisions. We support the nutrition assistance and food distribution programs for nearly 40 million people with low-income, e.g. ((SNAP Supplemental Nutrition Assistance Program, The Emergency Food Assistance Program (TEFAP) and preserving the current SNAP entitlement and funding structure to ensure benefit adequacy without work requirements. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 200 I to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. G2211 Add on Code Implementation: ACP urged Congress to support the full implementation of a Medicare add-on code, known as G2211, in 2024. This code will improve Medicare beneficiaries access to high-quality, continuous care and help sustain the physician practices beneficiaries rely on for comprehensive health care. G2211 would be billed alongside codes for office/outpatient evaluation and management (E/M) visits to better account for the unique and inherent complexity of services provided through longitudinal patient care that is based on a clinicians ongoing relationship with a patient and is related to a patients single, serious condition or a complex condition. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. MACRA Reform Hearings: We requested Congressional hearings on The Medicare Access and CHIP Reauthorization Act (MACRA) to focus upon whether the current system achieves the Congressional intent to move towards value- based care and to consider the long-term viability of the current Medicare physician payment system. These hearings should focus on the characteristics of a rational Medicare payment system. This should include: 1) Positive consistent and stable annual payment updates that offer the financial stability needed for our physicians to transition their practices to value-based payment models; 2) Meaningful and actionable quality reporting initiatives that adequately measure the quality of care our physicians provide to their patients; AND 3) A sufficient number of Advanced APMs for our physicians to join to provide high quality value-based care to their patients. Pricing Transparency/Consolidation: Supported several provisions of H.R. 5378, Lower Costs, More Transparency Act, which are consistent with our policy and would improve access to and affordability of health care for patients. This bill brings together H.R. 4822, Health Care Price Transparency Act of 2023, H.R. 3561, Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023 and other related bills reported out of Ways and Means, Energy and Commerce and Education and Workforce Committees. Supported requiring disclosure of changes in hospital or health facility ownership to reveal when private equity firms acquire hospitals, larger physician practices or nursing homes, promote price transparency among hospitals, health plans and pharmacy benefit managers and promote site neutrality for Medicare and Medicare beneficiaries. We further supported the reauthorization and funding increases included for the Teaching Health Center Graduate Medical Education program, Community Health Center program and National Health Service Corps. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes. Advocated against a March 2023 ruling by a federal judge in Texas that the ACA's requirements for coverage for preventive services will harm the health of Americans. Previously, under the ACA, health insurance plans have been required to include coverage at no cost to patients for preventive services recommended by the U.S. Preventive Services Task Force. These preventive services include cancer screenings, mental health screenings, heart disease and hypertension screenings, among other services. Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. FY2024 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vil, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include at least $11.581 billion for the CDC's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies appropriations bill. Submitted FY2024 report language to Congress regarding the overestimation of utilization of new codes. Supported $60 million for Public Health Infrastructure and Capacity, $400 million for Title X Family Service Grants, and $35 million for CDC Firearm Injury Prevention and Control. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S. 323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Prescription Drug Reform: Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Supported H.R. 4895, the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029. Social Determinants of Healthcare: Urged Congress to support legislation to expand utilization of social determinants of healthcare to expand governments capabilities to provide healthcare to underserved and disadvantaged communities. Supported the Improving the Social Determinants of Health Act of 2023 that would: award grants to state, local, territorial, and Tribal health agencies and organizations to address SDOHs in target communities; award grants to nonprofit organizations and institutions of higher education to conduct research on SDOH best practices; provide technical assistance, training, and evaluation assistance to target community grantees; and disseminate best practices; and collect and analyze data related to SDOH activities. Supported Donald McEachin Environmental Justice for All Act, H.R. 1705 and S. 1606. The bill contains environmental justice requirements, advisory bodies, and programs to address the disproportionate adverse human health or environmental effects of federal laws or programs on communities of color, low-income communities, or tribal and indigenous communities. Specifically, the bill prohibits disparate impacts on the basis of race, color, or national origin as discrimination. Aggrieved persons may seek legal remedy when faced with such discrimination. In addition, the bill directs agencies to follow certain requirements concerning environmental justice. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 2I and be subject to a criminal background check. Urged Congress to support the Bipartisan Background Checks Act, H.R. 715, and the Background Check Expansion Act, S. 494 and Ethans Law, H.R. 660 and S. 173, requiring gun owners to safely and securely store their firearms. Supported the Keep Americans Safe Act, H.R. 625 and S. 298, which would ban the importation, sale, manufacture, transfer, or possession of high-capacity gun magazines that hold more than fifteen rounds. Supported the Extreme Risk Protection Order Expansion Act, H.R. 768 and S. 247 empowering family members and law enforcement to prevent gun violence by petitioning a court to temporarily separate an at-risk individual from firearms. We supported the FY2024 funding gun violence prevention research contained in FY24 Senate Labor-HHS-Ed appropriations bill for inclusion in any final FY24 appropriations bills. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors' Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Mental and Behavioral Health: Urged members of Congress to cosponsor and reintroduces H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs. Supported S. 1378, the Connecting Our Medical Providers with Links to Expand Tailored and Effective Care or the COMPLETE Care Act, to improve the integration of behavioral health in primary care practices.

Expand Patient Access and Telehealth: Urged Congress to support several bills to expand patient access to medical coverage. ACP supports H.R. 1114, the Long COVID Response is Care Optimized and Vitally Essential Resources that Yield New Opportunities for Wellness Act or the Long COVID RECOVERY NOW Act, which would optimize care by enhancing a coordinated federal government response, public education and insurance reimbursement guidance for Long COVID. H.R. 1114 would also authorize the Secretary of Health and Human Services to provide grants to primary care practices to facilitate the adoption of evidence-based Long COVID clinical practices that have been demonstrated to improve the wellness of individuals with Long COVJD and submission of data to HHS on the characteristics, diagnoses, and health care service utilization of Long COVID patients. Urged Congress to pass H.R. 952, the Kids Access to Primary Care Act, which ensures that Medicaid payment rates for primary care services are equal to Medicare rates. The ACA included a provision that required states to raise Medicaid payment rates for primary care services equal to Medicare rates in 2013 and 2014 but this provision expired after those two years and was not renewed by Congress. Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported H.R. 2829, the Chronic Care Management Improvement Act of 2023, that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported Black Maternal Health Momnibus Act, H.R. 3305 and S. 1606, to improve maternal health, particularly among racial and ethnic minority groups, veterans, and other vulnerable populations. It also addresses maternal health issues related to COVID-19. The Department of Health and Human Services (HHS) and other specified departments would address the social determinants of maternal health, which include childcare, housing, food security, transportation, and environmental conditions. The bill also extends to 24 months postpartum eligibility for the Special Supplemental Nutrition Program for Woman, Infants, and Children. Additionally, HHS and other agencies must take actions to grow and diversify the maternal health workforce. To increase access to maternity care, HHS and other agencies must 1) award specified grants; 2) test an alternative payment model for perinatal care under Medicaid and the Children's Health Insurance Program (CHIP); and 3) support training, technology, and telehealth initiatives. Supported the Public Health Infrastructure Saves Lives Act, S. 1995, that provides annual funding for the CDC to strengthen core public health infrastructure. Core public health infrastructure includes the elements and workforce capabilities that enable health departments to perform critical functions such as disease surveillance and emergency response. Specifically, the CDC must award grants to health departments for their core infrastructure needs. In addition, the CDC must support the development of accreditation standards for health departments that emphasize core public health infrastructure. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Supporting those provisions in the 2023 Farm Bill, the 5-year reauthorization legislation, related to food and nutrition - namely food security and Supplemental Nutrition Assistance Program (SNAP) provisions. We support the nutrition assistance and food distribution programs for nearly 40 million people with low-income, e.g. ((SNAP Supplemental Nutrition Assistance Program, The Emergency Food Assistance Program (TEFAP) and preserving the current SNAP entitlement and funding structure to ensure benefit adequacy without work requirements. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 200 I to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. G2211 Add on Code Implementation: ACP urged Congress to support the full implementation of a Medicare add-on code, known as G2211, in 2024. This code will improve Medicare beneficiaries access to high-quality, continuous care and help sustain the physician practices beneficiaries rely on for comprehensive health care. G2211 would be billed alongside codes for office/outpatient evaluation and management (E/M) visits to better account for the unique and inherent complexity of services provided through longitudinal patient care that is based on a clinicians ongoing relationship with a patient and is related to a patients single, serious condition or a complex condition. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. MACRA Reform Hearings: We requested Congressional hearings on The Medicare Access and CHIP Reauthorization Act (MACRA) to focus upon whether the current system achieves the Congressional intent to move towards value- based care and to consider the long-term viability of the current Medicare physician payment system. These hearings should focus on the characteristics of a rational Medicare payment system. This should include: 1) Positive consistent and stable annual payment updates that offer the financial stability needed for our physicians to transition their practices to value-based payment models; 2) Meaningful and actionable quality reporting initiatives that adequately measure the quality of care our physicians provide to their patients; AND 3) A sufficient number of Advanced APMs for our physicians to join to provide high quality value-based care to their patients. Pricing Transparency/Consolidation: Supported several provisions of H.R. 5378, Lower Costs, More Transparency Act, which are consistent with our policy and would improve access to and affordability of health care for patients. This bill brings together H.R. 4822, Health Care Price Transparency Act of 2023, H.R. 3561, Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023 and other related bills reported out of Ways and Means, Energy and Commerce and Education and Workforce Committees. Supported requiring disclosure of changes in hospital or health facility ownership to reveal when private equity firms acquire hospitals, larger physician practices or nursing homes, promote price transparency among hospitals, health plans and pharmacy benefit managers and promote site neutrality for Medicare and Medicare beneficiaries. We further supported the reauthorization and funding increases included for the Teaching Health Center Graduate Medical Education program, Community Health Center program and National Health Service Corps. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes. Advocated against a March 2023 ruling by a federal judge in Texas that the ACA's requirements for coverage for preventive services will harm the health of Americans. Previously, under the ACA, health insurance plans have been required to include coverage at no cost to patients for preventive services recommended by the U.S. Preventive Services Task Force. These preventive services include cancer screenings, mental health screenings, heart disease and hypertension screenings, among other services. Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. FY2024 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vil, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include at least $11.581 billion for the CDC's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies appropriations bill. Submitted FY2024 report language to Congress regarding the overestimation of utilization of new codes. Supported $60 million for Public Health Infrastructure and Capacity, $400 million for Title X Family Service Grants, and $35 million for CDC Firearm Injury Prevention and Control. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S. 323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Prescription Drug Reform: Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Supported H.R. 4895, the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029. Social Determinants of Healthcare: Urged Congress to support legislation to expand utilization of social determinants of healthcare to expand governments capabilities to provide healthcare to underserved and disadvantaged communities. Supported the Improving the Social Determinants of Health Act of 2023 that would: award grants to state, local, territorial, and Tribal health agencies and organizations to address SDOHs in target communities; award grants to nonprofit organizations and institutions of higher education to conduct research on SDOH best practices; provide technical assistance, training, and evaluation assistance to target community grantees; and disseminate best practices; and collect and analyze data related to SDOH activities. Supported Donald McEachin Environmental Justice for All Act, H.R. 1705 and S. 1606. The bill contains environmental justice requirements, advisory bodies, and programs to address the disproportionate adverse human health or environmental effects of federal laws or programs on communities of color, low-income communities, or tribal and indigenous communities. Specifically, the bill prohibits disparate impacts on the basis of race, color, or national origin as discrimination. Aggrieved persons may seek legal remedy when faced with such discrimination. In addition, the bill directs agencies to follow certain requirements concerning environmental justice. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 2I and be subject to a criminal background check. Urged Congress to support the Bipartisan Background Checks Act, H.R. 715, and the Background Check Expansion Act, S. 494 and Ethans Law, H.R. 660 and S. 173, requiring gun owners to safely and securely store their firearms. Supported the Keep Americans Safe Act, H.R. 625 and S. 298, which would ban the importation, sale, manufacture, transfer, or possession of high-capacity gun magazines that hold more than fifteen rounds. Supported the Extreme Risk Protection Order Expansion Act, H.R. 768 and S. 247 empowering family members and law enforcement to prevent gun violence by petitioning a court to temporarily separate an at-risk individual from firearms. We supported the FY2024 funding gun violence prevention research contained in FY24 Senate Labor-HHS-Ed appropriations bill for inclusion in any final FY24 appropriations bills. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors' Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Mental and Behavioral Health: Urged members of Congress to cosponsor and reintroduces H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs. Supported S. 1378, the Connecting Our Medical Providers with Links to Expand Tailored and Effective Care or the COMPLETE Care Act, to improve the integration of behavioral health in primary care practices.

Abortion access (general); Access to Mifepristone (general); Contraception (general); Maternal Mortality and Morbidity (general); S. ___, Expanded Genetic Screening Act; H.R. 734, Protection of Women and Girls in Sports Act; H.R. ___, Indian Health Service Health Professions Tax Fairness Act of 2023; H.R. 1117, Advancing Safe Medications for Moms and Babies Act; H.Res. 309, Resolution expressing the sense of Congress that the Food and Drug Administration (FDA) has the authority to approve drugs for abortion care; obstetric and gynecologic care in rural areas (general); S.___, MOMMIES Act; H.R. ___/S.___, MOMMAs Act; H.R. 3589/S. 1698, Affordability is Access Act of 2023; H.R. 3305/S. 1606, Black Maternal Health Momnibus Act; H.R. 952, Kids Access to Primary Care Act of 2023; H.R. 1202/S. 704, Resident Education Deferred Interest (REDI) Act; S. 462, Mental Health Professionals Workforce Shortage Loan Repayment Act of 2023; H.R. 2389/S. 1302, Resident Physician Shortage Reduction Act of 2023; H.R. 2569, Doctors of Community (DOC) Act; Teaching Health Center Graduate Medication Education (general); H.Res.351, Recognizing the impact the stigmatization of menstruation has on the lives of women, girls, and people who menstruate, and expressing support for the designation of the month of May as "National Menstrual Health Awareness Month"; H.R. 3633, PREVENT HPV Cancers Act of 2023; physician workforce and training (general); H.R. 3838, Preventing Maternal Deaths Reauthorization Act of 2023; H.R. 3226/S. 1573, PREEMIE Reauthorization Act of 2023; inclusion of pregnant and lactating individuals in research (general); Implementation of P.L. 115-320, Improving Access to Maternity Care Act; telemedicine (general); H.R. ___, SHINE for Autumn Act; Rural Residency Planning and Development (RRPD) Program; H.R. 2819, Good Samaritan Health Professionals Act of 2023; H.R. 3916/S. 1840, SCREENS for Cancer Act of 2023; H.R. 4189/S. 2016, CONNECT for Health Act of 2023; S. 2231, Maternal and Child Health Stillbirth Prevention Act; S. 1378, Connecting Our Medical Providers with Links to Expand Tailored and Effective Care; H.R. 3503, NIH Clinical Trial Diversity Act of 2023; H.R. 4121/S. 1999, Right to Contraception Act; H.R. 4147/S. 2024, Reproductive Health Care Training Act of 2023; Pandemic All-Hazards Preparedness Act reauthorization; Implementation of P.L. 117-328, Consolidated Appropriations Act, including the Pregnant Workers Fairness Act; Health Insurance Portability and Accountability Act (general); patient-physician relationship (general).

No Bill No. - Congressional Primary Care Caucus No Bill No. - Black Maternal Health Momnibus Act No Bill No. - Medicare Physician Payment Reform No Bill No. - MACRA Implementation No Bill No. - CY2024 Medicare Physician Fee Schedule No Bill No. - CY 2024 Medicare Inpatient Prospective Payment System No Bill No. - Site Neutrality and Consolidation No Bill No. - CMS Prior Authorization Rules (H.R. 952) Kids Access to Primary Care Act (H.R. 2400/S. 1165) The Reentry Act (H.R. 3074) Due Process Continuity of Care Act (H.R. 3766) Extending Access to Addiction Treatment Act

Client expense: $804,940 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Expand Patient Access and Telehealth: Urged Congress to support several bills to expand patient access to medical coverage. ACP supports H.R. 1114, the Long COVID Response is Care Optimized and Vitally Essential Resources that Yield New Opportunities for Wellness Act or the Long COVID RECOVERY NOW Act, which would optimize care by enhancing a coordinated federal government response, public education and insurance reimbursement guidance for Long COVID. H.R. 1114 would also authorize the Secretary of Health and Human Services to provide grants to primary care practices to facilitate the adoption of evidence-based Long COVID clinical practices that have been demonstrated to improve the wellness of individuals with Long COVJD and submission of data to HHS on the characteristics, diagnoses, and health care service utilization of Long COVID patients. Urged Congress to pass H.R. 952, the Kids Access to Primary Care Act, which ensures that Medicaid payment rates for primary care services are equal to Medicare rates. The ACA included a provision that required states to raise Medicaid payment rates for primary care services equal to Medicare rates in 2013 and 2014 but this provision expired after those two years and was not renewed by Congress. Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported Chronic Care Management Act that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported Black Maternal Health Momnibus Act, H.R. 3305 and S. 1606, to improve maternal health, particularly among racial and ethnic minority groups, veterans, and other vulnerable populations. It also addresses maternal health issues related to COVID-19. The Department of Health and Human Services (HHS) and other specified departments would address the social determinants of maternal health, which include childcare, housing, food security, transportation, and environmental conditions. The bill also extends to 24 months postpartum eligibility for the Special Supplemental Nutrition Program for Woman, Infants, and Children. Additionally, HHS and other agencies must take actions to grow and diversify the maternal health workforce. To increase access to maternity care, HHS and other agencies must 1) award specified grants; 2) test an alternative payment model for perinatal care under Medicaid and the Children's Health Insurance Program (CHIP); and 3) support training, technology, and telehealth initiatives. Supported the Public Health Infrastructure Saves Lives Act, S. 1995, that provides annual funding for the CDC to strengthen core public health infrastructure. Core public health infrastructure includes the elements and workforce capabilities that enable health departments to perform critical functions such as disease surveillance and emergency response. Specifically, the CDC must award grants to health departments for their core infrastructure needs. In addition, the CDC must support the development of accreditation standards for health departments that emphasize core public health infrastructure. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Supports those provisions in the 2023 Farm Bill, the 5-year reauthorization legislation, related to food and nutrition - namely food security and Supplemental Nutrition Assistance Program (SNAP) provisions. We support the nutrition assistance and food distribution programs for nearly 40 million people with low-income, e.g. ((SNAP Supplemental Nutrition Assistance Program, The Emergency Food Assistance Program (TEFAP) and preserving the current SNAP entitlement and funding structure to ensure benefit adequacy without work requirements. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 200 I to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes. Advocated against a March 2023 ruling by a federal judge in Texas that the ACA's requirements for coverage for preventive services will harm the health of Americans. Previously, under the ACA, health insurance plans have been required to include coverage at no cost to patients for preventive services recommended by the U.S. Preventive Services Task Force. These preventive services include cancer screenings, mental health screenings, heart disease and hypertension screenings, among other services. Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. FY2024 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vil, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include at least $11.581 billion for the CDC's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies appropriations bill. Submitted FY2024 report language to Congress regarding the overestimation of utilization of new codes. Supported $60 million for Public Health Infrastructure and Capacity, $400 million for Title X Family Service Grants, and $35 million for CDC Firearm Injury Prevention and Control. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S.323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Prescription Drug Reform: Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Social Determinants of Healthcare: Urged Congress to support legislation to expand utilization of social determinants of healthcare to expand governments capabilities to provide healthcare to underserved and disadvantaged communities. Supported the Improving the Social Determinants of Health Act of 2023 that would: award grants to state, local, territorial, and Tribal health agencies and organizations to address SDOHs in target communities; award grants to nonprofit organizations and institutions of higher education to conduct research on SDOH best practices; provide technical assistance, training, and evaluation assistance to target community grantees; and disseminate best practices; and collect and analyze data related to SDOH activities. Supported Donald McEachin Environmental Justice for All Act, H.R. 1705 and S. 1606. The bill contains environmental justice requirements, advisory bodies, and programs to address the disproportionate adverse human health or environmental effects of federal laws or programs on communities of color, low-income communities, or tribal and indigenous communities. Specifically, the bill prohibits disparate impacts on the basis of race, color, or national origin as discrimination. Aggrieved persons may seek legal remedy when faced with such discrimination. In addition, the bill directs agencies to follow certain requirements concerning environmental justice. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of2 I and be subject to a criminal background check. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors' Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Mental and Behavioral Health: Urged members of Congress to cosponsor and reintroduces H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs. Supported S. 1378, the Connecting Our Medical Providers with Links to Expand Tailored and Effective Care or the COMPLETE Care Act, to improve the integration of behavioral health in primary care practices.

Expand Patient Access and Telehealth: Urged Congress to support several bills to expand patient access to medical coverage. ACP supports H.R. 1114, the Long COVID Response is Care Optimized and Vitally Essential Resources that Yield New Opportunities for Wellness Act or the Long COVID RECOVERY NOW Act, which would optimize care by enhancing a coordinated federal government response, public education and insurance reimbursement guidance for Long COVID. H.R. 1114 would also authorize the Secretary of Health and Human Services to provide grants to primary care practices to facilitate the adoption of evidence-based Long COVID clinical practices that have been demonstrated to improve the wellness of individuals with Long COVJD and submission of data to HHS on the characteristics, diagnoses, and health care service utilization of Long COVID patients. Urged Congress to pass H.R. 952, the Kids Access to Primary Care Act, which ensures that Medicaid payment rates for primary care services are equal to Medicare rates. The ACA included a provision that required states to raise Medicaid payment rates for primary care services equal to Medicare rates in 2013 and 2014 but this provision expired after those two years and was not renewed by Congress. Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported Chronic Care Management Act that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported Black Maternal Health Momnibus Act, H.R. 3305 and S. 1606, to improve maternal health, particularly among racial and ethnic minority groups, veterans, and other vulnerable populations. It also addresses maternal health issues related to COVID-19. The Department of Health and Human Services (HHS) and other specified departments would address the social determinants of maternal health, which include childcare, housing, food security, transportation, and environmental conditions. The bill also extends to 24 months postpartum eligibility for the Special Supplemental Nutrition Program for Woman, Infants, and Children. Additionally, HHS and other agencies must take actions to grow and diversify the maternal health workforce. To increase access to maternity care, HHS and other agencies must 1) award specified grants; 2) test an alternative payment model for perinatal care under Medicaid and the Children's Health Insurance Program (CHIP); and 3) support training, technology, and telehealth initiatives. Supported the Public Health Infrastructure Saves Lives Act, S. 1995, that provides annual funding for the CDC to strengthen core public health infrastructure. Core public health infrastructure includes the elements and workforce capabilities that enable health departments to perform critical functions such as disease surveillance and emergency response. Specifically, the CDC must award grants to health departments for their core infrastructure needs. In addition, the CDC must support the development of accreditation standards for health departments that emphasize core public health infrastructure. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Supports those provisions in the 2023 Farm Bill, the 5-year reauthorization legislation, related to food and nutrition - namely food security and Supplemental Nutrition Assistance Program (SNAP) provisions. We support the nutrition assistance and food distribution programs for nearly 40 million people with low-income, e.g. ((SNAP Supplemental Nutrition Assistance Program, The Emergency Food Assistance Program (TEFAP) and preserving the current SNAP entitlement and funding structure to ensure benefit adequacy without work requirements. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 200 I to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes. Advocated against a March 2023 ruling by a federal judge in Texas that the ACA's requirements for coverage for preventive services will harm the health of Americans. Previously, under the ACA, health insurance plans have been required to include coverage at no cost to patients for preventive services recommended by the U.S. Preventive Services Task Force. These preventive services include cancer screenings, mental health screenings, heart disease and hypertension screenings, among other services. Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. FY2024 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vil, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include at least $11.581 billion for the CDC's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies appropriations bill. Submitted FY2024 report language to Congress regarding the overestimation of utilization of new codes. Supported $60 million for Public Health Infrastructure and Capacity, $400 million for Title X Family Service Grants, and $35 million for CDC Firearm Injury Prevention and Control. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S.323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Prescription Drug Reform: Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Social Determinants of Healthcare: Urged Congress to support legislation to expand utilization of social determinants of healthcare to expand governments capabilities to provide healthcare to underserved and disadvantaged communities. Supported the Improving the Social Determinants of Health Act of 2023 that would: award grants to state, local, territorial, and Tribal health agencies and organizations to address SDOHs in target communities; award grants to nonprofit organizations and institutions of higher education to conduct research on SDOH best practices; provide technical assistance, training, and evaluation assistance to target community grantees; and disseminate best practices; and collect and analyze data related to SDOH activities. Supported Donald McEachin Environmental Justice for All Act, H.R. 1705 and S. 1606. The bill contains environmental justice requirements, advisory bodies, and programs to address the disproportionate adverse human health or environmental effects of federal laws or programs on communities of color, low-income communities, or tribal and indigenous communities. Specifically, the bill prohibits disparate impacts on the basis of race, color, or national origin as discrimination. Aggrieved persons may seek legal remedy when faced with such discrimination. In addition, the bill directs agencies to follow certain requirements concerning environmental justice. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of2 I and be subject to a criminal background check. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors' Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Mental and Behavioral Health: Urged members of Congress to cosponsor and reintroduces H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs. Supported S. 1378, the Connecting Our Medical Providers with Links to Expand Tailored and Effective Care or the COMPLETE Care Act, to improve the integration of behavioral health in primary care practices.

The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Advocated against a March 2023 ruling by a federal judge in Texas that the ACAs requirements for coverage for preventive services will harm the health of Americans. Previously, under the ACA, health insurance plans have been required to include coverage at no cost to patients for preventive services recommended by the U.S. Preventive Services Task Force. These preventive services include cancer screenings, mental health screenings, heart disease and hypertension screenings, among other services. Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Expand Patient Access: Urged Congress to support several bills to expand patient access to medical coverage. ACP supports H.R. 1114, the Long COVID Response is Care Optimized and Vitally Essential Resources that Yield New Opportunities for Wellness Act or the Long COVID RECOVERY NOW Act, which would optimize care by enhancing a coordinated federal government response, public education and insurance reimbursement guidance for Long COVID. H.R. 1114 would also authorize the Secretary of Health and Human Services to provide grants to primary care practices to facilitate the adoption of evidence-based Long COVID clinical practices that have been demonstrated to improve the wellness of individuals with Long COVID and submission of data to HHS on the characteristics, diagnoses, and health care service utilization of Long COVID patients. Urged Congress to pass H.R. 952, the Kids Access to Primary Care Act, which ensures that Medicaid payment rates for primary care services are equal to Medicare rates. The ACA included a provision that required states to raise Medicaid payment rates for primary care services equal to Medicare rates in 2013 and 2014 but this provision expired after those two years and was not renewed by Congress. Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 2001 to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Urged Congress to also: 1) provide a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced APM incentive payments for additional years to continue to recruit new providers into APMs. Additionally, to ensure that qualifying thresholds remain attainable to promote program growth, CMS should be given authority to adjust thresholds through rulemaking and to set varying thresholds for more targeted models where participants cannot meet the existing one-size-fits-all thresholds; 2) remove distinctions (i.e., the high-low revenue designation in the Medicare Shared Savings Program) that penalize safety net providers, improve financial methodologies so that APM participants are not penalized for their own success, reduce regulatory burdens by offering increased flexibilities and waivers for clinicians moving to risk, and provide technical assistance and an appropriate glidepath to financial risk for those newly transitioning to APMs; 3) work with the CMS Innovation Center to ensure that promising models have a more predictable pathway for being implemented and becoming permanent and are not cut short due to overly stringent criteria; and 4) should seek greater alignment between APMs and the MA program to ensure that both models provide attractive, sustainable options for innovating care delivery, and to ensure that APMs do not face a competitive disadvantage. FY2024 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Preventions programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title VII, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Preventions (CDC) Office on Smoking and Health (OSH). Urged Congress to include at least $11.581 billion for the CDCs programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies appropriations bill. Submitted FY2024 report language to Congress regarding the overestimation of utilization of new codes. Womens Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Prescription Drug Reform: Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Acts prescription drug negotiation provisions. Firearm Safety (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 21 and be subject to a criminal background check. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: 1) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Mental and Behavioral Health: Urged members of Congress to cosponsor and reintroduce s H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs.

The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Advocated against a March 2023 ruling by a federal judge in Texas that the ACAs requirements for coverage for preventive services will harm the health of Americans. Previously, under the ACA, health insurance plans have been required to include coverage at no cost to patients for preventive services recommended by the U.S. Preventive Services Task Force. These preventive services include cancer screenings, mental health screenings, heart disease and hypertension screenings, among other services. Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Expand Patient Access: Urged Congress to support several bills to expand patient access to medical coverage. ACP supports H.R. 1114, the Long COVID Response is Care Optimized and Vitally Essential Resources that Yield New Opportunities for Wellness Act or the Long COVID RECOVERY NOW Act, which would optimize care by enhancing a coordinated federal government response, public education and insurance reimbursement guidance for Long COVID. H.R. 1114 would also authorize the Secretary of Health and Human Services to provide grants to primary care practices to facilitate the adoption of evidence-based Long COVID clinical practices that have been demonstrated to improve the wellness of individuals with Long COVID and submission of data to HHS on the characteristics, diagnoses, and health care service utilization of Long COVID patients. Urged Congress to pass H.R. 952, the Kids Access to Primary Care Act, which ensures that Medicaid payment rates for primary care services are equal to Medicare rates. The ACA included a provision that required states to raise Medicaid payment rates for primary care services equal to Medicare rates in 2013 and 2014 but this provision expired after those two years and was not renewed by Congress. Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 2001 to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Urged Congress to also: 1) provide a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced APM incentive payments for additional years to continue to recruit new providers into APMs. Additionally, to ensure that qualifying thresholds remain attainable to promote program growth, CMS should be given authority to adjust thresholds through rulemaking and to set varying thresholds for more targeted models where participants cannot meet the existing one-size-fits-all thresholds; 2) remove distinctions (i.e., the high-low revenue designation in the Medicare Shared Savings Program) that penalize safety net providers, improve financial methodologies so that APM participants are not penalized for their own success, reduce regulatory burdens by offering increased flexibilities and waivers for clinicians moving to risk, and provide technical assistance and an appropriate glidepath to financial risk for those newly transitioning to APMs; 3) work with the CMS Innovation Center to ensure that promising models have a more predictable pathway for being implemented and becoming permanent and are not cut short due to overly stringent criteria; and 4) should seek greater alignment between APMs and the MA program to ensure that both models provide attractive, sustainable options for innovating care delivery, and to ensure that APMs do not face a competitive disadvantage. FY2024 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Preventions programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title VII, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Preventions (CDC) Office on Smoking and Health (OSH). Urged Congress to include at least $11.581 billion for the CDCs programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies appropriations bill. Submitted FY2024 report language to Congress regarding the overestimation of utilization of new codes. Womens Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Prescription Drug Reform: Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Acts prescription drug negotiation provisions. Firearm Safety (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 21 and be subject to a criminal background check. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: 1) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Mental and Behavioral Health: Urged members of Congress to cosponsor and reintroduce s H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs.

No Bill No. - Congressional Primary Care Caucus No Bill No. - Black Maternal Health Momnibus Act No Bill No. - Medicare Physician Payment Reform (H.R. 952) Kids Access to Primary Care Act

Client expense: $744,939 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

No Bill No. - Congressional Primary Care Caucus No Bill No. - Black Maternal Health Momnibus Act No Bill No. - Medicare Physician Payment Reform (H.R. 952) Kids Access to Primary Care Act

Client expense: $788,015 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE